Manage the full cycle of accounts receivable for Workers' Compensation, including billing, claim corrections, and follow-ups to reduce delinquency. Review claim information for accuracy and coordinate with clinical areas to resolve errors and denials.
Job DetailsLevel: ExperiencedJob Location: Houston, TX 77030Position Type: Full TimeEducation Level: High School/GEDJob Category: Health CareGENERAL JOB DESCRIPTION
Medical Billing Workers' Compensation AR Specialist will be well versed in all facets of an accounts receivable management system including but not limited to billing, claim corrections, reconciliation, Insurance refunds/credit balances, customer service, and follow-up. This includes reviewing claim information to ensure accuracy and provide feedback to the clinical and non-clinical areas regarding claim errors and/or denials. In addition, responsible for all other aspects of collections, resolving customer billing problems and reducing accounts receivable delinquency. Medical Billing Workers' Compensation AR Specialist will work remotely.
ESSENTIAL FUNCTIONS
• Medical Billing Workers' Compensation A/R Clean up, Collections and Review.
• Follow-up on all returned claims, correspondence, denials, account reconciliations and rebills to achieve maximum reimbursement in a timely manner with an emphasis on patient satisfaction.
• Mail correspondence to insurance carrier for payment of claims in the form of claim review and/or appeals according to carrier guidelines.
• Review and monitor assigned accounts and all applicable collection reports.
• Follow-up claim reviews and appeals with insurance carriers.
• Scan and fax documents pertaining to patient accounts received from carriers.
• Actively searches for solutions to problems and presents ideas and recommendations to Management.
• Retroactive verification of eligibility.
• Always attempt to verify inaccurate/missing information.
• Other duties as assigned.
EQUIPMENT AND MATERIALS USED
Telephone – with or without headset - constantly.
Computer – constantly
Ten key - constantly
QualificationsQUALIFICATIONS
Education
• High School Diploma or equivalent. (Required)
Experience
1 year of experience in Workers' Compensation Billing and AR collections; preferably in physician office setting.
Medical Appeals and Denials: 1 year. (Required)
Minimum of 1 year’s knowledge of insurance verification and eligibility experience. (Required)
Spine/Orthopedic medicine billing knowledge and experience (Preferred)
Knowledge and experience with Athena EMR. (Preferred, but not required)
High School Diploma or equivalent. (Required)
Special Skills
• Knowledge of medical and insurance terminology.
• Attention to detail.
• Ability to effectively communicate both orally and written.
• Ability to work in a fast-paced environment.
PHYSICAL DEMANDS
• Must have adequate visual acuity to read, the ability to interpret and understand written material.
• Ability to sit for extended periods.
• Repetitive movement of fingers and hands.
• Reaching with hands and arms.
• Ability to lift 10-20 pounds.
• Read, evaluate, and interpret data.
• Data entry.
• Perform mathematical functions.
ENVIORNMENTAL WORKING CONDITIONS
• Continuously manage multiple tasks simultaneously and work as a part of a team
• Remote office environment