Claims Verification Specialist for Workers Compensation and No Fault

Job Description

About the Company

CitiMed is a unique medical facility that provides exclusive healthcare amenities to our community. The range of medical and rehabilitative services offered has been specifically selected to treat traumatic injury patients. We provide a variety of health services including diagnostic and rehabilitation. Our vision directs the evolution of our practice, as we strive to improve our services to the community. All CitiMed offices are multilingual and staffed with individuals to make any experience pleasant. You can learn more about us at CitiMed is growing rapidly and we are looking for many qualifying individuals to be a part of our team! With the support and hard work of all our employees, CitiMed continues to make its way down a successful road. 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!

Claims Verification Specialist (Entry Level)

We're looking for someone detail-oriented to help make sure patient and insurance information is accurate and complete for No-Fault (PIP), Workers' Compensation, and lien cases. In this role, you'll check that patient details and documents are correct, confirm coverage with insurance carriers, and stay in touch with patients' attorneys to keep claims moving smoothly. Your work helps prevent delays and protects the practice's ability to get reimbursed on time.

What You'll Do

You'll start by reviewing patient information, names, IDs, and supporting documents to make sure everything is accurate before a claim moves forward. You'll reach out to insurance carriers, employers, attorneys, and third-party administrators to confirm things like coverage, accident details, and claim numbers. You'll also communicate directly with patients' attorneys to confirm representation and exchange any documents needed to resolve open issues.

Part of your role is making sure paperwork like ID, referrals, and attorney information is collected before or during scheduling, and that records stay current in the practice's system. You'll work closely with scheduling staff to track down anything missing before a patient's visit, and you'll flag any verification issues to the billing team quickly, since claims need to be billed within 7 days of the visit.

You'll keep an eye on active claims to catch any changes in eligibility or coverage, follow up with carriers and attorneys when needed, and help make sure claims are coded correctly when a patient has more than one type of coverage. Keeping clear notes on every conversation is important here, since your documentation supports audits and compliance reviews. You'll also work alongside scheduling, billing, and clinical teams across multiple locations, and take part in periodic quality reviews to help strengthen how the team works.

What We're Looking For

• At least 1 year of experience with Workers' Compensation or No-Fault claims, or related insurance/claims work
• Comfortable learning insurance terminology and processes if not already familiar
• Highly detail-oriented, with strong problem-solving skills
• Able to think quickly and make sound decisions under pressure
• Clear, adaptable communicator who works well with a range of personalities
• Comfortable following up with carriers, attorneys, and internal teams to resolve issues

Pay range and compensation package

Job Type: Full-time

Benefits: 401(k), Health insurance

Equal Opportunity Statement

CitiMed is committed to diversity and inclusivity in the workplace.