This role is responsible for managing the full revenue cycle for Workers’ Compensation and Personal Injury prescription claims, with direct accountability for reducing Accounts Receivable and driving timely, accurate reimbursement.
Responsibilities
Manage the full billing and collections lifecycle for a defined book of Workers’ Compensation and Personal Injury prescription claims
Maintain and thoroughly work a minimum of 40+ patient accounts, ensuring consistent progress toward resolution
Review and prioritize aging reports daily to proactively reduce 60/90/120+ day AR and accelerate reimbursement
Analyze EOBs, notices of disallowance, state fee schedule variances, and payment discrepancies to identify root causes and independently execute the appropriate resolution strategy
Track and resolve unpaid and underpaid claims to ensure accurate reimbursement in accordance with contractual terms and state fee schedules
Requirements
Nice to have: Workers’ Compensation billing experience
Nice to have: billing medications/pharmacy-related services
Nice to have: Workers' compensation billing and claims
Overseeing timely and accurate application of insurance and patient payments, reconciling payments to bank deposits, and ensuring compliance with HIPAA and healthcare revenue cycle regulations.
Responsibilities
Oversee timely, accurate application of insurance and patient payments received through ERA, EFT, ACH, lockbox, credit card, check, and other channels
Co-own reconciliation of posted payments to bank deposits, remittance data, and general ledger activity in partnership with Finance and Accounting
Ensure compliance with HIPAA, payer requirements, governmental regulations, audit standards, and established financial controls
Lead efforts to identify and resolve patient and payer credit balances, overpayments, duplicate payments, and misapplied transactions
Ensure timely investigation and resolution of unapplied cash, misapplied payments, posting errors, payment variances, and missing remittance activity
Requirements
High School Diploma or equivalent
Bachelor's degree in Finance, Accounting, Business Administration, Healthcare Administration, or related field preferred
Responsible for performing revenue cycle tasks for TELCOR Revenue Cycle Service customers, including client, insurance, and patient billing, and managing claims resolution processes.
Locations (5)
Nebraska, United States
Texas, United States
Kansas, United States
Arkansas, United States
Arizona, United States
Responsibilities
Analyze and investigate claim rejections, payer rejections, and payer denials
Reimbursement SpecialistNewAdvanced Rx Management · Remote, US
Billing Specialist - Pediatrics - Oak GroveCommunity Health Systems · Hattiesburg, US
Patient Account RepresentativeTEKsystems · Remote, US
Manager Posting and CreditsSimonMed Imaging · Remote
Claims Resolution SpecialistTELCOR, Inc. · Remote, US+4 more