Medical Billing, Appeals Specialist – Workers Compensation
Advanced Pain Care
full-time
Posted on:
Location Type: Hybrid
Location: Austin • Texas • United States
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Salary
💰 $20 - $25 per hour
About the role
- Reviews and appeal unpaid and denied worker’s compensation claims
- Attaches appropriate documents to appeal letters
- Obtains pre-authorization for worker’s compensation office visits and procedures
- Researches and evaluates insurance payments and correspondence for accuracy
- Logs appeals and grievances, and tracks progress of claims
- Keeps up-to-date reports and notates any trends pertaining to insurance denials
- Calls insurance companies to inquire about claims, refund requests and payments
- Utilizes EMR system to submit and correct claims
- Posts patient and insurance payments
- Sends paper claims to insurance carriers
- Answers patient billing questions
- Coordinates medical and billing records payments with patients and/or third party payers
- Handles collections on unpaid accounts
- Identifies and resolves patient billing complaints
- Answers phone calls to the Billing Department in a timely and professional manner
- Processes credit card payments over the phone and in person
- Serves and protects the practice by adhering to professional standards, policies and procedures, federal, state, and local requirements
- Enhances practice reputation by accepting ownership for accomplishing new and different requests; exploring opportunities to add value to job accomplishments
- Operates standard office equipment (e.g. copier, personal computer, fax, etc.).
- Has regular and predictable attendance
- Adheres to Advanced Pain Care’s Policies and procedures
- Performs other duties as assigned
Requirements
- Requires a high school diploma or GED; workers’ compensation adjuster license desired
- Three or more years related work experience of training; previous job experience in worker’s compensation
- Clear and precise communication
- Ability to pay close attention to detail
- Effectively manages day by organizing and prioritizing
- Possesses excellent phone and customer service skills and abilities
- Protects patient information and maintains confidentiality
- Knowledge of general medical terminology, CPT, ICD-9 and ICD-10 coding
- Familiarity with analyzing electronic remittance advice and electronic fund transfers
- Experience interpreting zero pays and insurance denials
- Competence in answering patient questions and concerns about billing statements
- Organizational skills and ability to identify, analyze and solve problems
- Works well independently as well as with a team
- Strong written and verbal communication skills
- Interpersonal/human relations skills
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
worker’s compensation claims reviewinsurance payment evaluationclaims trackingEMR system utilizationCPT codingICD-9 codingICD-10 codinganalyzing electronic remittance adviceinterpreting insurance denialscollections management
Soft Skills
clear communicationattention to detailorganizational skillscustomer service skillsproblem-solving skillsindependent workteam collaborationstrong written communicationstrong verbal communicationinterpersonal skills
Certifications
high school diplomaGEDworker’s compensation adjuster license