Workers Compensation Administrator jobs in Raleigh, NC

Wake Spine and Pain is seeking Medical Billing Specialists with experience with Workers Compensation claims

Experience with EMR required. eClinicalWorks experience is preferred.

Candidates must be resourceful in obtaining information regarding billing/coding changes, display the ability to interact with patients in a professional manner (in person and via the phone) and excel in customer service.

We offer a collaborative, team-oriented work environment and competitive compensation package (401k, medical, vision, dental benefits, life insurance, PTO package, paid holidays, STD/LTD, no weekends, etc.).

As a Medical Billing Specialist- Workers Compensation, you will be responsible for, but not limited to:

• Creating claims
• Reviewing medical records for accuracy
• Claim submissions
• Coding medical records
• ERA posting and review
• Posting manual payments
• Working denials and filing appeals
• Working AR reports
• Manage patient accounts
• Verifies patient insurance coverage timely utilizing phone or online resources to ensure necessary procedures are covered.
• Enters data timely in an accurate manner into the EMR system and verifies that existing information is accurate.
• Serves as a valuable resource to patients, providing them with pertinent information regarding their coverage.
• Authorizations for procedure, DME and lab services
• Submits all necessary authorization requests for services prior to being rendered.
• Ensures all pertinent medical documentation is accurate and present prior to submission.
• Assures authorizations or referrals have been approved with the proper CPT and ICD10 codes prior to services being rendered.
• Follows up with pending authorizations on a regular basis to obtain the current status or to be informed of any action needed in order to obtain the authorization approval.
• Communicates any authorization denials to the appropriate staff.
• Keeps patients abreast of the current status of their authorization if waiting time has exceeded the usual and customary expected time.
• Documents authorization details, status, and end result into EMR timely and prior to services being rendered.
• Handles any discrepancies, errors, or omissions of authorization denials.
• Schedules peer to peers with providers and communicates such meetings appropriately.
• Works collaboratively with the entire billing department to meet company goals.
• Participates in educational activities and attends regular staff and department meetings.
• Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations.
• Stays abreast with current and upcoming payer billing requirements and regulations.

Competencies

• Knowledge of the complete revenue cycle management model
• Strong understanding of medical terminology
• Working knowledge of payer billing requirements and regulations
• Strong organizational and multitasking skills
• Solid attention to detail to ensure accuracy of information
• Must be able to work independently and show leadership in decision making
• Excellent computer skills

Job Type: Full-time

Pay: $18.00 - $20.00 per hour

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• Day shift
• Monday to Friday

Application Question(s):

• What are your salary requirements? (hourly rate)

Experience:

• Medical Billing: 2 years (Required)
• Workers' compensation: 1 year (Required)

Ability to Relocate:

• Raleigh, NC 27609: Relocate before starting work (Required)

Work Location: In person