What are the responsibilities and job description for the WORKERS' COMPENSATION ACCOUNT REPRESENTATIVE position at OrthoEconomics?
We are seeking a detail-oriented and experienced Workers’ Compensation Account Representative to join our growing medical billing team. The ideal candidate will have a strong understanding of workers' compensation billing, claims follow-up, payment posting, denial management, and payer regulations.
Position Summary
The Workers’ Compensation Account Representative is responsible for managing and resolving outstanding workers’ compensation accounts receivable, ensuring accurate reimbursement, and maintaining compliance with state-specific workers’ compensation guidelines.
Essential Duties and Responsibilities
- Follow up on unpaid and underpaid workers’ compensation claims.
- Investigate and resolve claim denials, payment discrepancies, and billing issues.
- Communicate with insurance adjusters, nurse case managers, attorneys, and employer representatives.
- Verify claim status, authorization requirements, and payment information.
- Submit reconsiderations, appeals, and supporting documentation as necessary.
- Monitor accounts receivable aging and work assigned accounts to resolution.
- Review EOBs, medical records, and billing documentation for accuracy.
- Maintain detailed account notes and documentation within practice management systems.
- Meet productivity and collection goals established by management.
- Stay current on state workers’ compensation regulations and payer requirements.
Required Qualifications
- High school diploma or equivalent required.
- Minimum of 2 years of workers’ compensation billing or accounts receivable experience preferred.
- Knowledge of medical billing, CPT, ICD-10, and HCPCS coding.
- Experience with claim appeals and denial management.
- Strong analytical and problem-solving skills.
- Excellent verbal and written communication abilities.
- Proficiency with electronic medical records (EMR) and billing software.
- Ability to work independently and manage multiple priorities.
Preferred Qualifications
- Experience in orthopedic, surgical, or specialty physician practice billing.
- Certified Professional Biller (CPB) or related certification preferred.
- Familiarity with state fee schedules and workers’ compensation regulations.
Benefits
Pay: From $21.00 per hour
Expected hours: No less than 40.0 per week
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Retirement plan
- Vision insurance
Work Location: In person
Salary : $21