Workers Compensation Billing Assistant

Job Description

Job Description

Description : Summary / Objective

The mission of Work Health Solutions is to help individuals and organizations work to their fullest and safest capacity. Central to this mission is a commitment to professionalism and kindness. Our core principle is simple : always be nice. We aim to foster cooperation among staff and clientele, while upholding high standards of professionalism. As occupational health specialists, our primary responsibility is ensuring people can safely return to work, enabling them to provide for their families.

The Workers' Compensation Billing Assistant supports the billing department by handling the timely and accurate processing of workers' compensation claims. This role involves working closely with front office staff, providers, employers, adjusters, and insurance carriers to ensure claims are submitted correctly and paid in accordance with workers' compensation guidelines.

Expected Hours of Work

Days and hours of work are Monday through Friday, 8 : 00 a.m. to 5 p.m. Work during inclement weather and overtime may be required.

Work Environment

This job operates in a healthcare setting. This role requires regular walking to various locations around the clinic. This role also routinely comes into contact with patients who may have contagious illnesses.

Physical Demands

While performing the duties of this job, the employee is regularly required to talk and hear. This position is very active and requires standing, walking, bending, kneeling, and stooping all day. The employee must frequently lift and / or move items over 20 pounds. Ability to reach above shoulder height, at desk height, and below desk height.

Core Responsibilities

• Review clinical documentation for completeness and compliance before billing (Chart Audit)
• Verify patient, employer, and payor information for billing accuracy (Confirm Payor / Claim Number)
• Respond to inquiries from insurance adjusters, employers, and internal staff (Communicate / Collaborate)
• Prepare and submit invoices for injury care in standard and HICF formats to payor (Create / Submit Invoices)
• Track claim status and maintain organized records of all billing activities (Document All Actions)
• Assist with reconciling accounts and resolving outstanding balances (AR)
• Follow up on unpaid or denied claims, identify root causes, and take corrective actions (Collections)
• Back up Referrals-Collaborate with providers to obtain necessary documentation for referral. Communicate with company representatives and adjusters to obtain payor information / claim number. Submit referral order to specialist for continuity of care. Document status of referral.

Other Duties

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.

Supervisory Responsibility

This position has no supervisory responsibilities.

Requirements : Key Qualifications

Preferred Education and Experience

Required Education and Experience

Additional Eligibility Qualifications