Early Dispute Resolution Specialist I

Description

ABOUT GEMINI LEGAL

If you are seeking meaningful work in a company that values integrity, innovation, and growth, consider a career with Gemini Legal.

Headquartered in Rocklin, California, Gemini Legal is an industry-leading legal support company serving attorneys across California. Our proprietary, in-house developed technology platform powers efficient, secure digital record collection and workflow management. In addition to records services, we provide vocational counseling to injured workers, delivering comprehensive support throughout the life of a case.

Our growth is powered by our people. We operate with an open-door leadership philosophy and a culture built on accountability, collaboration, and service. We promote from within whenever possible and invest in individuals who demonstrate commitment and potential, including those new to the industry.

Ethical. Passionate. Smart. These principles guide how we work, how we serve clients, and how we support one another.

Job Summary

The Early Dispute Resolution (EDR) Specialist I’s objective is to ensure prompt payment from all responsible parties by verifying billing and case party information, issuing compliant and complete invoices, responding timely to EORs/objections, and engaging carriers when there is no response to payment demands within the economic cycle between 1 - 365 days from the date of service. This position includes compliance with HIPAA, state, and federal document security regulations. Specialists receive training in workers’ compensation laws, regulations, and copy service fee schedules related to all aspects of billing and objections. As a member of the Economic Cycle team, the EDR Specialist I is a thorough, diligent, motivated, and detail-oriented contributor.

• Location: Rocklin, CA/ West Covina, CA/Hybrid-Remote
• Schedule: Monday-Friday, 8:00am-5:00pm
• Compensation: $19.23-$25.96 Per Hour
  
  

The pay range for this role is $19.23-$25.96. Starting pay for new hires is typically within the lower third of the range: $19.23-$21.47. Exceptions may be made based on factors such as education, specialized skills, or significant relevant experience.

Requirements

RESPONSIBILITIES

• Remain up-to-date with changing regulations and requirements related to workers' compensation billing in California
• Ensure all billing practices comply with legal and ethical standards
• Identify and resolve billing issues, discrepancies, and objections
• Effectively manage multiple claims and billing tasks
• Ensure timely submission and follow-up of all billing related documentation
• Safeguard patient and claim information to ensure privacy and compliance with HIPAA, State, and Federal regulations
• Collaborate with other professionals, such as bill reviewers, claims adjusters, and opposing counsel to process workers' compensation claims efficiently
• Provides assistance to stakeholders in understanding workers' compensation billing and resolving inquiries or disputes
• Interact with insurance companies and attorneys as needed
• Other duties as required
  
  

What You Bring

• Education and/or experience:
• High School diploma or equivalent is required
• 3 years of previous customer service or accounts receivable experience strongly preferred
• 1 years of experience in the workers compensation field, especially with a focus on workers' compensation copy service billing, strongly preferred
• Experience using medical billing software and electronic health record (EHR) systems is a plus
• Skills:
• Excellent written communication skills, including proof-reading, syntax, and grammar
• Typing speed of at least 35 WPM with 90% accuracy
• Problem solving skills
• Keen attention to detail
• Ability to work both independently and as part of a team
• General computation skills, including the use of a calculator
• Ability to learn new tasks within Litigation Support and Accounts Receivable as needed
• Proficiency in workers’ compensation terminology and copy service workers' compensation billing codes
• Familiarity with insurance and legal terminology related to workers' compensation claims
• Knowledge of California's workers' compensation system, including its rules, regulations, and fee schedules
• Understanding of the necessary documentation and paperwork required for workers' compensation billing
• Technology
• Proficient using a computer, business phone, office software, video conferencing, and other computer programs including Google Workplace (Docs, Sheets, Calendar, Gmail, etc.), Microsoft applications, EAMS, Daisy Bill, and MerusCase
• Experience with project management software such as Asana preferred
• Familiarity with spreadsheet and database software for data entry, tracking, and managing billing and objection data
  
  

Functional Requirements

Must be able to perform the essential functions of the position with or without accommodation, including, but not limited to:

• Sitting for at least one hour at a time (total: 4-6 hours/day)
• Keyboarding for extended periods of time (total: 4-6 hours/day)
• Using a phone with or without a headset for extended periods (total: 3-5 hours/day)
  
  

What You’ll Love About Gemini Legal

Full-Time Team Members

• Comprehensive medical, dental, and vision coverage
• Generous paid time off, including PTO, sick leave, volunteer time, and paid holidays
• 401(k) plan with company match
• Tuition reimbursement program
• Employee Assistance Program and legal assistance benefit
• Company-paid annual charitable donation in your name
• Employee recognition program
  
  

Salary Description

$19.23-$25.96 Per Hour