This position is responsible for submission and management of workers' compensation billing claims. This includes filing claims, posting payments, addressing errors, reviewing and appealing denials, notifying team of regulatory changes, managing the fee schedule, keeping clinic team apprised of information key to successful claims processing. . Further responsible for supporting the team with other medical and occupational health billing tasks.

• Responds to verbal and written questions from payers, patients, and staff
• Identifies and resolves denials, rebills and/or appeals as necessary to effect payment.
• Performs various collection activities to follow up on un-adjudicated claims including contacting insurers and patients by phone, preparing written appeals with appropriate documentation
• Takes patient payments over the phone and documents details for credit card processing. Refers requests for settlement arrangements to appropriate management for approval
• Performs daily outgoing payer activities in an effort to secure appropriate reimbursement
• As necessary, deciphers payment vouchers and reconciles accounts to bill secondary or patient balances and resolve contractual allowances appropriately
• Maintains working knowledge of payer and government-specific requirements and apply to daily billing and follow-up activities
• Identifies and reports payer trends related to inappropriate reimbursement, denials, etc. to leadership
• Maintains confidentiality of patient information as mandated by HIPAA guidelines
• Meets deadlines and offers assistance in completing projects
• Interacts appropriately with physicians and other colleagues
• As necessary, provides cross coverage for billing/follow up specialists within the department
• Ensures 100% compliance with the organizational Compliance Program and compliance with federal and state licensing requirements

• High school diploma or equivalent required, Associates Degree preferred
• Minimum one year workers compensation billing experience preferred
• Must know how to read and decipher NYS Workers Compensation Board decisions and denials
• Strong customer service skills
• Basic computer skills required to include accurate keyboarding. Accurately typing 40 WPM a plus
• Experience with Medent and Agility EMR preferred

EEO Employer:

WorkFit Medical, LLC is an equal opportunity employer and does not discriminate on the basis of any legally protected status or characteristic. Minority/Female/Sexual Orientation/Gender Identity/Disability/Veteran.

Applicants who require reasonable accommodations:

WorkFit Medical, LLC is committed to providing a work environment that is free from unlawful discrimination and harassment in any form. WorkFit Medical, LLC will endeavor to make a reasonable accommodation/modification to the known limitations of a qualified applicant with a disability to assist in the hiring process, unless the accommodation would impose an undue hardship on the operation of our business, in accordance with applicable federal state and local law. Applicants who require reasonable accommodation pursuant to ADA, during the application process, are encouraged to contact 585-247-9040 to ask for assistance.

To apply please furnish your cover letter, resume, and salary requirements.

WorkFit Medical, 1160 Chili Avenue, Rochester, NY 14624

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