AR Executive Medical Billing
5 days ago
Job Advert: Senior AR Specialist – Workers' Comp, PIP, & No-Fault Claims
Are You a Claims-Juggling Expert? Master the Revenue of the Most Complex Medical Billing Systems
Cyber System is a rapidly growing leader in [Your Industry/Specialty, e.g., Orthopedics, Physical Therapy, Revenue Cycle Management]. We are seeking a highly skilled and analytical AR Specialist to join our team, focusing exclusively on the challenging and lucrative Accounts Receivable (AR) for Workers' Compensation (WC), Personal Injury Protection (PIP), and No-Fault claims.
If you thrive on uncovering denied revenue, navigating state-specific fee schedules, and closing out high-dollar, multi-party claims, this role is for you.
What You'll Do: The Core Mission
You will be the final authority and lead executor for our most complex and high-value AR accounts. Your primary mission is to ensure maximum, timely reimbursement for services rendered under WC, PIP, and No-Fault guidelines.
- Aggressive Claims Follow-Up: Manage a specialized aging report, prioritizing accounts based on value and timely filing limits for WC, PIP, and No-Fault claims.
- Denial Management & Appeals: Investigate and resolve all claim denials, including those related to compensability, medical necessity, pre-authorization, and state fee schedule discrepancies. Draft and submit formal first- and second-level appeals.
- Fee Schedule Mastery: Expertly read, interpret, and apply state-specific Workers' Compensation Fee Schedules and No-Fault state regulations to ensure accurate payment.
- Payer Communication: Maintain professional, results-driven communication with WC Adjusters, PIP Carriers, and legal firms to push claims to final payment or settlement.
- Coordination of Benefits (COB): Navigate complex scenarios where WC and PIP are secondary to each other or another insurance, ensuring proper balance-billing rules are followed.
- What You'll Bring: Essential Qualifications3+ years of dedicated, hands-on experience managing Accounts Receivable for Workers' Compensation and/or Personal Injury Protection (PIP)/No-Fault medical claims.
- In-depth knowledge of at least one major No-Fault state (e.g., NY, FL, MI, NJ) regulations and their corresponding medical fee schedules.
- Proven ability to successfully overturn denied claims and reduce days in AR for complex payer groups.
- Strong understanding of medical terminology, CPT/ICD-10 codes, and their impact on claims adjudication.
- Exceptional organizational skills and the ability to manage a high-volume pipeline of complex cases with detailed documentation.
Employment Type
Full-time
Apply:
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Location 03 fane road Mazang Lahore
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