Workers Compensation Specialist

Practitioners

Thank you for considering a career within Signature Medical Group!

We are looking for talented people to join our team of dedicated team members, and have career opportunities available at a variety of locations throughout the greater St. Louis and Kansas City regions.

All applicants MUST include a resume to be considered for a position with Signature Medical Group.

Date Posted: 12/8/2020
Department: Orthopedics - Human Resources
Type of Employment: Full-Time

JOB TITLE: Workers’ Compensation Specialist
GENERAL SUMMARY OF DUTIES: Investigates and bills workers’ compensation claims and resolve troubled and/or denied workers compensation claims.

ESSENTIAL FUNCTIONS:

  • Reviews provider account notes and account history. Obtains accident details, employer contact information and worker’s comp carrier/claim information.
  • Bills workers' comp carriers. Obtains and verifies claim information, accident details, carrier billing information, and necessary billing documents from providers.
  • Performs follow-up activities with employers, carriers, adjusters and patients. Verifies bill is on file; verifies required documentation was received; and obtains bill processing status.
  • Resolves regular, disputed and denied accounts through communication with adjusters and patients.
  • Proactively identifies systemic client issues, such as underpayments, service line issues, etc) and reports these issues to department management.
  • Performs follow-up activities with adjusters to verify receipt of appeal letters, obtain EOB’s, request bill review explanations and/or documentation, dispute charges, dispute contracts, obtain payment information, and provide supporting documentation to support appeal, applicable when working with High Dollar accounts.
  • Performs special projects or tasks as assigned.
  • Will not disclose Protected Health Information (PHI) in violation of law.

Job Knowledge, Skills and Abilities Required

  • Ability to communicate effectively verbally and in writing.
  • Ability to speak on a one-to-one basis with patients, attorneys and adjusters using appropriate vocabulary and grammar to explain what is required and obtain information.
  • Demonstrated ability to work independently and follow-through on assignments with minimal direction.
  • Working knowledge or ability to learn state workers’ compensation laws and regulations as assigned.
  • Skilled in problem resolution and processing numerous types of denials.
  • Must be able to produce accurate work while maintaining attention to detail.
  • Willingness to work cooperatively in a team environment.
  • Must have a high level of attention to detail and be skilled in organizing and prioritizing work.
  • Proven experience processing Workers' Compensation claims on behalf of healthcare providers strongly preferred, but not required.

Education and Experience Requirements

  • High School Diploma or equivalent.
  • At least one-year overall work experience, preferably in a professional office environment.

Job Type: Full-time

Pay: From $14.00 per hour

Benefits:

  • 401(k)
  • 401(k) matching
  • Dental insurance
  • Flexible spending account
  • Health insurance
  • Life insurance
  • Paid time off
  • Vision insurance

Schedule: 8 hour shift

Ability to Commute/Relocate: St. Louis, MO 63128 (Preferred)

Experience: Work Comp: 1 year (Preferred)


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