Medical Biller- Workers Compensation Claims
2 weeks ago
We are seeking an experienced Medical Biller specializing in Workers' Compensation claims to join our team. The ideal candidate will have a strong background in medical billing, claim submission, and payment follow-up, with a proven ability to handle complex workers' comp claims efficiently.
Key Responsibilities
- Prepare, review, and submit workers' compensation medical claims to insurance companies and third-party administrators (TPAs).
- Ensure billing compliance with state-specific workers' comp regulations and guidelines.
- Verify patient insurance eligibility and authorization for services.
- Accurately post payments, adjustments, and denials in billing systems.
- Follow up on unpaid or denied workers' compensation claims; resolve rejections in a timely manner.
- Maintain regular communication with insurance carriers, adjusters, and physician offices.
- Prepare appeal letters and supporting documentation for denied or underpaid claims.
- Generate and review aging reports; manage accounts receivable effectively.
- Ensure compliance with HIPAA and confidentiality standards.
- Collaborate with providers, front-office staff, and case managers to ensure billing accuracy.
Qualifications
- Required:
2+ years of experience in medical billing with direct experience in
Workers' Compensation claims. - Strong knowledge of
ICD-10, CPT, HCPCS codes
and medical billing procedures. - Familiarity with
EOBs, AR reports,
and medical billing software (e.g., AdvancedMD, Kareo, Epic, or similar). - Strong understanding of
state-specific workers' comp guidelines
and payer requirements. - Excellent communication and negotiation skills for dealing with payers and adjusters.
- High attention to detail and problem-solving skills.
- Ability to work independently and meet deadlines in a fast-paced environment.
Preferred Skills
- Experience with
multi-specialty billing
(e.g., Orthopedics, Physical Therapy, Pain Management). - Knowledge of
Medicare/Medicaid
in addition to workers' comp. - Bilingual (English/Spanish) is a plus.
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