Early Dispute Resolution Specialist II

Description

COMPANY INTRODUCTION

Gemini’s vision and opportunity is to earn respect as the leading provider of ethical, quality legal support products and services to a growing number of attorneys and types of law. We deliver on our mission through principled, personal leadership. We embrace and meet our clients’ true needs by providing a safe, stable and competitive work environment where employees, clients and vendors enrich ?their community and themselves personally and professionally.

A Little Bit About Us

If you're looking for a rewarding career at a company with a supportive workplace culture and unlimited potential for growth, consider Gemini Legal. We are a dynamic, industry-leading, technology-based company headquartered in Rocklin, California. Gemini provides support services to California attorneys, collecting digital records and offering vocational counseling to injured workers.

Our management team has an open-door policy, and our exceptional growth is credited solely to our team members and their dedication to collaborate, achieve and give back. Success is celebrated and integrity is the essence of who we are.

Ethical. Passionate. Smart. These three tenets drive our diverse team, and we welcome dedicated individuals to apply to join our work family.

A Little Bit About The Position

The Early Dispute Resolution (EDR) Specialist II’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 II is a thorough, diligent, motivated, and detail-oriented contributor.

• Location: Rocklin, CA or West Covina, CA/Hybrid-Remote
• Schedule: Monday-Friday, 8:00am-5:00pm
• Compensation: $21.63-$28.37
  
  

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 accurate billing and objection responses
• 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
  
  

Experience, Skills And Abilities

• Education and/or experience:
• High School diploma or equivalent is required
• 3 years of previous customer service or accounts receivable experience strongly preferred
• 3 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
• Basic computer skills, including data entry
• Typing speed of at least 35 WPM with 90% accuracy
• Problem solving skills
• Ability to work both independently and as part of a team
• Ability to learn new tasks within legal and accounts receivable as needed
• General computation skills, including the use of a calculator
• 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 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

• Comprehensive health coverage including medical, dental, and vision
• Generous time-off to support work-life balance including PTO, volunteer time, sick time, and paid holidays
• 401(k) plan with company match to support your financial future
• Company culture rooted in shared values and community
• Education tuition reimbursement program
• Employee Assistance Program (EAP) and legal assistance benefit
• Company-paid annual donation to a non-profit or charity of your choice
• Employee recognition program with gifts and awards
  
  

Salary Description

$21.63-$28.37 Per Hour