Worker's Compensation Account Specialist

Job Description

Job Description

The Workers Compensation (WC) Account Specialist is responsible for account management of applicable workers compensation cases. The WC Account Specialist will verify, secure authorizations as required by insurance carriers, making notification to adjusters to verify cases. In addition, WC Account Specialist will be responsible for Account Receivable (AR) follow-up with the payers to bring accounts to claim resolution.

Essential Functions :

• Obtains all required authorizations for patient via internet and / or phone in a timely manner and at times with a sense of urgency;
• Responds promptly to inquires received from clinics either via telephone, email or tasking;
• Keeps providers abreast of patient authorization status including approvals and denials;
• Contacts insurance companies and escalates issues when authorization approvals and claim payments are not received timely;
• Reviews work ques on a daily basis to ensure productivity standards on patient account authorization and A / R follow up is maintained;
• Assists in identifying denial trends for under and overpayments by insurance carriers and escalates as necessary;
• Assists in providing resolution to unpaid, unresolved accounts with payers;
• Maintain working knowledge of HIPAA, OSHA, Risk Management and Compliance practices;
• Attends staff meetings and assigned training as required;

Requirements

including private, commercial and government claims;

Benefits

Hourly Pay Rate : $22.64-$25.13