POSITION SUMMARY: Our Healthcare organization is seeking experience Workers Compensation Collections Specialist to join our team. The ideal candidates will have a strong background in Work Comp Collections functions and will report directly to the team lead and the Manager of Work Comp Collections. Position is 90% remote after in-office training subjected to change based on business needs.

 

ESSENTIAL FUNCTIONS

Performs all functions according to established policies, procedures, regulatory and accreditation requirements, as well as applicable professional standards. Provides all internal and external customers of Physicians Immediate Care with an excellent service experience by consistently (1) supporting the Company’s goals and mission, (2) following all Company policies and procedures, (3) providing quality customer service, and (4) following safety standards in performing all aspects of the functions below.

 

  • Workers Compensation Collections: Utilize A/R reports/system worklists to identify accounts that are past timely payment. Contact employer or third party administrator to obtain claim information or claim number so claim can be resubmitted when appropriate
  • Appeals: Write appeals to employers or third party administrators to overturn denied or short paid claims
  • Medical Billing: Re-bill claims that are not on file at the employer or third party administrator and provide substantiating documentation if necessary
  • Documentation: Obtain necessary documentation (updated medical order, clinical notes, patient agreement, etc.) and submit to employer or third party administrator
  • Patient/Provider: Contact patient and/or provider to relay and obtain pertinent information and/or documents to assist in the collection of claims
  • Research and resolve incorrect payments
  • Answer patient inquires by phone regarding outstanding account balances and work comp guidelines
  • Post adjustment entries
  • Identify and prepare insurance refunds to employer or third party administrator
  • Perform other duties as assigned
  • Ensure that all information regarding collection activity of account is entered accurately into the billing system
  • Bring recurring issues /trends to the attention of the department manager

QUALIFICATIONS

  • High School Diploma or equivalent required
  • Minimum 3-5 years of experience in work comp collections
  • Experience working with employers and third party administrators
  • Strong analytical skills
  • Excellent phone skills
  • Computer Savvy
  • Quick learner
  • Ability to handle multiple tasks simultaneously under strict deadlines
  • Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations

 

At Physicians Immediate Care you will enjoy full benefits including a generous wellness plan, a company matched 401K plan, a Monday through Friday schedule with a great work-life balance. Come join our team!

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