Workers’ Compensation (WC) Supervisor

The Workers’ Compensation (WC) Supervisor is responsible for the oversight, coordination, and optimization of all workers’ compensation workflows across assigned practice locations. This role ensures efficient claim processing, timely authorizations, accurate documentation, and seamless coordination between clinical teams and external stakeholders.

The WC Supervisor plays a critical role in supporting orthopaedic providers by ensuring that all components of the workers’ compensation lifecycle—from initial intake through return-to-work—are executed with operational excellence, regulatory compliance, and a focus on patient outcomes and employer satisfaction.

Essential Functions

Workers’ Compensation Program Oversight

• Oversee the end-to-end workers’ compensation process across assigned clinics to ensure consistency, efficiency, and compliance.
• Serve as the subject matter expert (SME) for all WC-related workflows, payer requirements, and regulatory guidelines.
• Develop, implement, and maintain standardized workflows to improve operational performance and reduce delays in care.
• Monitor and address workflow gaps impacting patient access, authorizations, and claim progression.

Patient Intake & Claims Management

• Ensure all WC patients are accurately registered with verified demographics, insurance, and authorization status prior to services being rendered.
• Act as the primary liaison between the clinic and external stakeholders, including employers, adjusters, nurse case managers, and legal representatives.
• Ensure all required documentation (e.g., work status forms, DWC forms, medical records) is completed, received, and distributed timely.
• Maintain accurate tracking of claims and ensure documentation aligns with clinical services rendered.

Clinical Coordination & Authorizations

• Oversee the timely submission and follow-up of all authorization requests for surgeries, imaging, injections, and durable medical equipment (DME).
• Partner with physicians, clinical staff, and surgery scheduling teams to ensure all required documentation supports medical necessity and payer requirements.
• Ensure alignment between provider dictation, orders, and authorization submissions to prevent denials or delays.
• Escalate authorization barriers and collaborate with leadership and payers to resolve issues efficiently.

Return-to-Work (RTW) & Care Coordination

• Ensure work status documentation is completed accurately and communicated to all required parties within established timeframes.
• Monitor and track patient progress to support timely return-to-work outcomes.
• Communicate functional limitations, restrictions, and light-duty status clearly to employers and case managers.
• Coordinate ancillary services, including physical therapy (PT), imaging, and functional capacity evaluations (FCEs), to support continuity of care.

Performance Monitoring & Reporting

• Track and report key performance indicators (KPIs), including:

• • Authorization turnaround times
  • Surgical conversion rates for WC patients
  • Work status form completion and timeliness
  • Days to return-to-work
  • WC case volume and growth trends
  • Analyze data to identify trends, barriers, and opportunities for operational improvement.
  • Provide regular reporting and updates to clinic and market leadership.

Education, Training & Staff Development

• Provide ongoing education and training to physicians and clinic staff on WC processes, documentation requirements, and regulatory updates.
• Ensure providers understand the importance of timely and accurate dictation to support authorizations and claims processing.
• Train and mentor WC coordinators and administrative staff to ensure consistency across locations.

Business Development & Market Growth

• Partner with marketing and leadership to support growth of the WC program across the East TN market.
• Build and maintain relationships with local employers, adjusters, and case managers.
• Participate in networking events and outreach efforts to increase WC referrals and case volume.
• Identify opportunities to expand services and improve employer engagement.

Supervisory Responsibilities

• Direct oversight of Workers’ Compensation Coordinators and/or support staff (if applicable).
• Responsible for training, performance management, and workflow accountability within the WC function.

Qualifications

Education:

• High School Diploma required; Associate’s or Bachelor’s degree in Healthcare Administration or related field preferred.

Experience:

• Minimum 3–5 years of workers’ compensation experience in a healthcare setting required.
• Orthopaedic or surgical practice experience strongly preferred.
• Previous leadership or supervisory experience preferred.

Knowledge & Skills:

• Strong knowledge of workers’ compensation processes, payer requirements, and regulatory compliance.
• Understanding of orthopaedic workflows, surgical scheduling, and medical terminology.
• Ability to manage multiple priorities and drive process improvements in a fast-paced environment.
• Strong communication, organizational, and problem-solving skills.
  Proficiency in EMR systems and Microsoft Office applications.

Work Environment & Physical Demands

• Primarily office and clinical setting with frequent interaction with patients, providers, and external stakeholders.
• Prolonged periods of sitting, standing, and computer use.