WC (Workers Compensation) Claims Analyst Position Available In Manatee, Florida
Tallo's Job Summary: The WC Claims Analyst position at Transcend Health Solutions in Bradenton, Florida involves reviewing and processing WC claims, communicating with adjusters and employers, and submitting appeals when necessary. Qualified candidates must have expert knowledge of WC claims processes, medical terminology, and strong communication skills. A minimum of 2 years of experience in VA claims, medical billing, or claims resolution is required, with a preference for a Bachelor's degree. Familiarity with WC-specific portals and proficiency in Microsoft Office are preferred skills for this full-time role.
Job Description
WC (Workers Compensation) Claims Analyst
Transcend Health Solutions, LLC
Bradenton, Florida
Key ResponsibilitiesReview and process WC claims by gathering medical records, itemized bills, and employer/patient information.
Submit claims to WC carriers in accordance with state-specific statutes and billing rules.
Verify eligibility, claim status, and payer responsibility with adjusters and employers.
Communicate professionally with insurance adjusters, employers, and patients to resolve claim barriers and expedite processing.
Review Explanation of Benefits (EOBs) or remittance advices for accuracy and next steps.
Prepare and submit appeals when claims are denied or underpaid, referencing applicable WC rules and documentation.
Ensure all activities are documented clearly and timely in claim management systems.
Maintain compliance with HIPAA and confidentiality standards.
Escalate complex claim issues or legal barriers to leadership as needed.
Meet productivity goals while maintaining excellent attendance, attention to detail, and accuracy.________________________________________Required QualificationsExpert knowledge of WC claims processes, including writing effective appeals and reconsiderations.
Strong knowledge of medical terminology, coding (ICD-10, CPT, HCPCS), and healthcare billing principles.
Excellent communication and problem-solving skills.
Strong working knowledge of workers’ compensation statutes and regulations in multiple states (e.g., FL, GA, AL, OK, MO, TX).Experience handling WC claims from submission through resolution.
Proficiency in interpreting EOBs, state fee schedules, and medical documentation.
Ability to communicate clearly and professionally with adjusters, employers, patients, and healthcare providers.
Highly organized and detail-oriented with excellent follow-up skills.
Proven track record of excellent attendance and reliability.
High School Diploma required; Bachelors degree preferred, or equivalent combination of education and experience.
Minimum of 2 years experience in VA claims, medical billing, or claims resolution.________________________________________Preferred SkillsFamiliarity with WC-specific portals (e.g., Georgia SBWC, Corvel, Georgia DOL, etc.)Experience with hospital lien filing and coordination of benefits.
Proficiency in Microsoft Office.
Knowledge of medical terminology and
ICD-10/CPT
coding.
Understanding of WC authorization and referral processes.
EHR experience.
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Not Specified
Job Information
Position Type:
Full Time
