WC Account Representative

Description

Position Summary:  

The workers compensation account representative is responsible for collections and follow-up with insurance companies to obtain prompt/accurate payment on accounts. workers compensation account representative will assist and manage all aspects of patient processing and accounts receivable functions of the organization including billing, charge entry, collections, registration, eligibility, follow-up, payment posting, patient collections and credit balance resolution. 

Duties and Responsibilities: 

• Interviewing patients to collect basic demographic information and financial/insurance data. 
• Verify and obtain insurance coverage and benefits via insurance company website, insurance eligibility programs or by telephone for all patients registered for services for all payer types. 
• Preparation, submission and management of claims to all insurance carriers. 
• Maintain knowledge of current billing requirements for all insurance carriers. 
• Track and monitor the financial activities of all patients with co-pays, deductibles, financials or liabilities. 
• Re-verify Medicaid monthly and commercial insurances each January. Obtains information regarding insurance benefits to determine patient responsibility 
• Resolve billing issues of outstanding claims providing information needed such as medical records or denials from other insurance plans and maintain current aging of accounts receivables. 
• Initiates contact with patients and/or third-party carriers if there is a delay in responding to statements or claims 
• Responsible for maintaining workload balance, ensuring maximum efficiency, eliminating rework, and reducing cost. 
• Review and respond timely to requests, including emails, telephone calls, issues, account research and resolution as needed by co-workers, management and clients. 
• Participate in meetings, conference calls and training sessions, including Management Meetings, Team Meetings, as well as any meetings while working telecommuting during assigned daily work schedule. 
• May process incoming and outgoing mail. 
• May receive incoming telephone calls and resolve issues communicated. 
• Interfaces with patients, physicians, and others regarding professional billing operations. 
• Assists in reviewing and balancing transaction reports for administration. 
• Reconciles daily receivables reports. 
• Performs various duties as needed in order to successfully fulfill the function of the position. 
• Ability to interpret and apply policies and procedures. 
• Other duties as assigned. This is a safety sensitive position. 

Qualifications: 

Education: 

• High School diploma and/or equivalent combination of education and experience 

Experience: 

• 12 months experience in Medical Billing, Medical Collections or Medical Billing Systems. 
• Experience with traditional insurance plans, HMO/PPO’s, Medicare, Medicaid, and Worker’s Comp. 

Skills: 

• Ability to use 10key by touch 
• Able to type 45 wpm 
• Basic Microsoft Excel and Word knowledge 
• Medical billing knowledge 
• Read EOB's (Explanations of Benefits) o Analytical skills 
• Organizational skills