The Workers Compensation (WC) Account Specialist is responsible for account management of applicable workers compensation cases. The WC Account Specialist will verify, secure authorizations as required by insurance carriers, making notification to adjusters to verify cases. In addition, WC Account Specialist will be responsible for Account Receivable (AR) follow-up with the payers to bring accounts to claim resolution. 

Essential Functions: 

• Obtains all required authorizations for patient via internet and/or phone in a timely manner and at times with a sense of urgency; 
• Responds promptly to inquires received from clinics either via telephone, email or tasking; 
• Keeps providers abreast of patient authorization status including approvals and denials; 
• Contacts insurance companies and escalates issues when authorization approvals and claim payments are not received timely; 
• Reviews work ques on a daily basis to ensure productivity standards on patient account authorization and A/R follow up is maintained; 
• Assists in identifying denial trends for under and overpayments by insurance carriers and escalates as necessary; 
• Assists in providing resolution to unpaid, unresolved accounts with payers; 
• Maintain working knowledge of HIPAA, OSHA, Risk Management and Compliance practices; 
• Attends staff meetings and assigned training as required; 

Requirements

• At least 2 years of experience working of medical billing, account receivable follow up, with a strong emphasis on denial management and third party policy;  
• Must have an understanding of clinic operations as it relates to patient registration, referrals, authorizations and cash collections; 
• Must possess strong leadership skills and strong attention to detail; 
• Must have an understanding of insurance payor reimbursement, authorization, collection practices and practice management systems; 
• Must have the ability to maintain the confidentiality of all records; 
• Must have the ability to manage multiple tasks and demands given while ensuring a high degree of accuracy and attention to detail; 
• Must have effective interpersonal and communication skills; 
• Must have knowledge of claims and authorizations processing for insurance companies
  including private, commercial and government claims; 

Benefits

Hourly Pay Rate: $19.50-$25.00