Collections Specialist

Workers' Compensation Collections Specialist

Nogales Psychological Counseling is a growing psychology practice specializing in California workers' compensation, medical-legal evaluations, and behavioral health services. We are seeking an experienced Workers' Compensation Collections Specialist to manage insurance collections, resolve outstanding balances, and maximize reimbursement while maintaining professional relationships with claims administrators, adjusters, and attorneys.

The Workers' Compensation Collections Specialist is responsible for collecting outstanding accounts receivable for psychological treatment and medical-legal services. This position requires strong knowledge of California workers' compensation billing and collections, including follow-up with insurance carriers, documentation review, denial resolution, payment reconciliation, and account resolution.

The ideal candidate is persistent, organized, analytical, and comfortable communicating with insurance adjusters, hearing representatives, attorneys, and internal staff.

Essential Duties and Responsibilities

• Monitor assigned workers' compensation accounts receivable.
• Review aging reports and prioritize collection efforts.
• Contact insurance adjusters, third-party administrators (TPAs), self-insured employers, and defense attorneys regarding unpaid claims.
• Research payment delays, denials, and underpayments.
• Submit appeals, reconsideration requests, and additional documentation when required.
• Prepare and send demand letters.
• Review Explanation of Benefits (EOBs), payment histories, and billing records.
• Identify billing errors and coordinate corrections with the billing department.
• Track statutes, filing deadlines, and collection timelines.
• Document all collection activity thoroughly within the practice management system.
• Follow up consistently until accounts are resolved.
• Coordinate with attorneys regarding liens, hearings, and collection strategies when appropriate.
• Assist with filing Declarations of Readiness (DORs) and other workers' compensation collection documents.
• Maintain accurate notes and collection status for every account.
• Identify trends causing payment delays and recommend process improvements.
• Meet monthly collection goals.

Qualifications

• Minimum 2 years of workers' compensation collections experience preferred.
• Knowledge of California Workers' Compensation billing processes.
• Experience working with insurance carriers and TPAs.
• Familiarity with medical billing, CPT codes, and payment reconciliation.
• Experience reviewing EOBs and denial letters.
• Strong negotiation and communication skills.
• Excellent organizational and time-management abilities.
• Ability to manage a high-volume caseload independently.
• Proficiency with Microsoft Excel and practice management software.
• Bilingual English/Spanish preferred but not required.

Preferred Experience

Experience with one or more of the following:

• Psychological treatment billing
• Medical-legal billing
• Liens
• DOR filings
• EAMS
• WCAB hearings
• California Labor Code and Medical-Legal Fee Schedule
• Insurance appeals
• Collections reporting and aging analysis

Skills

• Strong investigative and problem-solving abilities
• Attention to detail
• Professional written and verbal communication
• Ability to negotiate professionally
• Self-motivated with minimal supervision
• Excellent documentation skills
• Ability to manage competing priorities

What We Offer

• Competitive salary based on experience
• Paid time off
• Health, dental, and vision benefits
• Retirement plan
• Opportunities for professional growth
• Supportive team environment