Workers Compensation Claims Collection Associate

CitiMed, a fast growing facility, is hiring immediately a qualified WC collection associate for the WC billing/collection department. CitiMed maintains a work culture that allows our team members to feel supported and confident in their work. We offer many learning opportunities with room for professional growth. If the responsibilities interest you and believe you have met the requirements, we strongly encourage you to apply!

Job Description:

The workers' compensation claims collection associate is responsible for the independent, prompt, and efficient evaluation, investigation, and resolution of assigned claims in accordance with legal statutes, policy provisions, and company guidelines to achieve positive results.

Responsibilities:

Independent, prompt, and efficient evaluation, investigation, and resolution of assigned claims in accordance with legal statutes, policy provisions, and company guidelines to achieve positive results. Promptly investigate all assigned claims from basic to more complex medical and indemnity files with minimal supervision. Follow up on rejections, determinations, and unpaid claims to collect missing payments. Negotiate claims settlements within granted authority and accurately process and track award payments. Analyze all Notice of Decisions issued by the Workers' Compensation Law Judges as it pertains to any individual cases you might be working on, apply the Worker's Compensation Law Judge's C-8.1 ruling to any of your outstanding/disputed medical bills. Maintain current knowledge of all the forms used by the Workers' Compensation processes (C-3; C-2F; C-4; C-4.2; C-4AMR; C-4.3;

HCFA1500

; MG-2; MG-2.1; C4-AUTH; HP-1; HP-2; HP-3; HP-3.1; HPA204; C-8.1; C-8.4; EOR; NOD; NOPCD; RD; AD; MOBPD; NOA; EC-325),rules & regulations (Section 325-1.25;

HP-1/HP-J1

processes; Medical Treatment Guidelines &WC Medical Fee Schedule) Maintain a proper follow up system for all cases/claims that you previously worked on to ensure timely reimbursement. Maintain a proper system of communication with the WC Claim Department & WC Verification Department, inform them about any cases you encounter that might require any update for billing purposes (Incorrect carrier; change in claim, WCB no#, billing address, etc.) Always maintain proper communication with the AR Manager to address any arising issues that you might not be able to resolve on your own. Maintain current knowledge of New York jurisdictional requirements and applicable case law Preferred Experience  Minimum 2-5 years of workers' compensation billing and collection experience  Understanding of no fault & workers' compensation regulations in NY  Knowledge of HIPAA guidelines and compliance We are looking for someone who is/can  A Fast learner  Detailed Oriented  Work independently and efficiently  Analyze and problem solve independently  Has superb verbal and written communication skills  Flexible and can adjust to different situations  Work under pressure to meet productivity guidelines

Pay:

From $20.00 per hour

Benefits:

Health insurance Paid time off

Work Location:

In person