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.
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.
- 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
- 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)