Workers' Compensation Medical Billing Specialist

Job Description

Job Description

At Redefine Healthcare , we believe in providing all patients with the highest quality of care and compassion. With our dedicated team of Neurosurgeons, Interventional Pain Management Specialists, Orthopedists, Psychiatrists, Physical Therapists, and Chiropractors, we pride ourselves on specializing in continuity of care for our patients. We are excited to add Vascular to our growing list of specialties.

Redefine Healthcare is looking for a dedicated, full-time Workers’ Compensation Medical Billing Specialist to join our expanding team of healthcare professionals in our Matawan Office. The Workers’ Compensation Medical Billing Specialist is responsible for managing the billing and collection process for Workers’ Compensation claims. This role ensures accurate claim submission, payment posting, and follow-up with insurance carriers, third-party administrators, and adjusters to resolve outstanding balances or denied claims. We are looking for candidates that are motivated, compassionate and are looking to advance their career in a community that is always growing.

Job Title: Workers’ Compensation Medical Billing Specialist

Pay Rate: $21-25/ hour, depending on specialty and experience

Hours: 40 hours per week

Job Type : Full-time

Benefits: Paid time off, sick time, health insurance (medical, dental, vision, accident, and critical illness), life insurance, 401(k) with Company match, yearly bonus

Job Title Duties (not limited to):

• Process and submit medical claims related to Workers’ Compensation cases accurately and in a timely manner.
• Review patient accounts to ensure all Workers’ Compensation claim information (claim number, employer, insurance carrier, and adjuster details) is accurate and complete.
• Follow up with insurance carriers, third-party administrators (TPAs), and adjusters regarding claim status, payments, and denials.
• Investigate and resolve denied or unpaid Workers’ Compensation claims , ensuring proper documentation and resubmission when necessary.
• Communicate with patients, employers, insurance carriers, and adjusters regarding billing inquiries and claim updates.
• Ensure billing practices comply with Workers’ Compensation fee schedules, regulations, and payer guidelines .
• Post payments and adjustments accurately and reconcile accounts as needed.
• Maintain organized documentation for Workers’ Compensation claims and related correspondence.
• Work collaboratively with providers, front desk staff, and management to ensure accurate claim submission and timely reimbursement.
• Adhoc responsibilities and duties.

Experience Required:

• Proven experience in Workers’ Compensation medical billing or healthcare billing with Workers’ Compensation claims.
• Knowledge of Workers’ Compensation claim processes, insurance carriers, and fee schedules.
• Experience working with adjusters, employers, and third-party administrators (TPAs).
• Strong communication and problem-solving skills with the ability to professionally manage billing inquiries and claim issues.
• Strong attention to detail and ability to manage multiple claims and follow-ups efficiently.