Workers Compensation/No Fault Specialist

Essential Functions

·       Reviewing patient information and medical records to accurately prepare and submit claims to insurance companies.

·       Verifying insurance eligibility, benefits, and pre-authorizations to facilitate smooth claim processing.

·       Resolving billing discrepancies, denied claims, and rejected submissions in a timely manner.

·       Communicating with patients, insurance companies, and healthcare providers to address billing inquiries and resolve issues.

·       Analyze complex billing scenarios, identify discrepancies or errors, and find solutions to ensure accurate reimbursement.

·       Reconciling accounts, identifying delinquent accounts, and initiating collection procedures when necessary.

·       Stay up-to-date with regulations and changes in worker's compensation laws and billing guidelines to ensure accurate and compliant billing practices.

·       Collaborating with the billing team, administrative staff, and healthcare professionals to optimize revenue cycle management.

·       Regular and predictable attendance is an essential function of this position.

·       Other duties as assigned.

Qualifications

To perform this job successfully, an individual must be able to perform each essential function satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required.

Education/Experience

·        Comprehensive knowledge of No-Fault and Workers Compensation rules and regulations within NYS a must.

·        2+ years of billing experience.

·        Surgical billing experience HIGHLY preferred.

·        Medent (EMR System) experience a plus.

Skills/Abilities

·        Familiarity with all Microsoft Office applications.

·        Task oriented, pays attention to detail and can multitask.

·        Excellent organizational, verbal and written communication skills.

·        Good judgement, and a strong team player.