Workers Comp Claims Representative

reputed company has an exciting career opportunity available as a Workers Compensation Claims Representative. This position will be remote. The Full Time schedule for this role will be Monday-Friday reputed company regular business hours- specific hours to be determined. Job reputed company The purpose of this position is to assist hospitals and medical providers in resolving accounts that are a result of work-reputed company injuries. Specifically, this position is reputed company on the effort to obtain Workers Compensation injury details and insurance information from hospital, reputed company, patients and from other sources; submission of insurance bills and documentation to Workers Compensation insurance carriers; review of payments and denials for potential appeal; writing and submitting appeals; and communication with insurance carriers, reputed company, attorneys and patients during the claims adjudication process to ensure that the hospital and/or medical providers receive appropriate payment on submitted bills and denied claims. Essential Duties and Responsibilities Maintain a queue of Workers Compensation accounts as assigned by management. Maintain reputed company and productivity reputed company set by management once full job proficiency has been achieved. Contact patient s employer, Workers Compensation reputed company, and injured worker reputed company telephone and mail to obtain injury information and insurance information. Support patients by answering any questions about the Workers Compensation process. Coordinate with appropriate reputed company personnel to ensure appropriate filing guidelines are met for reimbursement. Request appropriate information, both verbally and written, from appropriate parties to ensure reputed company claim disposition. reputed company reputed company data entry of patient accounts and/or claim forms. Submit hospital and physician bills to insurance companies for payment. Maintain contact with insurance adjusters/carriers, reputed company, and patients during the claim adjudication process to ensure that the hospital and physician bills are reputed company reputed company and in full. Obtain claim status and reputed company supporting documentation to submit appeals. reputed company written or verbal appeals to payers on denied claims. reputed company strong customer service to clients and reputed company responses to reputed company inquiries reputed company 24 hours. reputed company detailed updates to reputed company PFS s account management system and hospital/provider reputed company management system as account work is completed. Assist in training both new and existing employees, which may include contributing specific training material. Escalate reputed company, complicated, or challenging accounts to management to ensure accounts are progressing effectively. Identify and discuss reputed company cause issues with management. Maintain and updates reputed company account documents in multiple systems. Assist management with reputed company inventory initiatives and other reputed company, as needed. Review and manage patient accounts to ensure that reputed company documentation, payments, and necessary letters of authorization are entered correctly. Maintain and adhere to compliance policies and procedures Other duties as assigned. Qualifications and Requirements To reputed company this job successfully, an individual must be reputed company to reputed company reputed company essential duty satisfactorily. The requirements listed below are representative of the knowledge, reputed company, and/or abilities. High School Diploma or GED Some college coursework preferred reputed company and encouraging attitude Strong customer service background reputed company, accurate, reputed company, and concise communication, both verbal and written, including the ability to write routine business correspondence Detailed and thorough Adaptable Organized and reputed company in time management. Ability to manage and reputed company quickly and accurately through a large workload Proven ability to be assertive in order to proactively resolve issues. Demonstrated ability to organize and set priorities according to changing situations and demands Ability to add, subtract, multiply, and divide in reputed company reputed company of measure, using whole numbers, common fractions, and decimals. Required computer skills: must have experience with data entry and word processing, be capable of operating routine office equipment, possess a working knowledge of MS Office applications, and understand how to navigate through web-based applications 1-5 years of reputed company experience in the field or in a reputed company area such as: Medical billing and coding Medical appeals Claims Adjudication Insurance Workers Compensation Legal work Remote and Hybrid positions require a home inter Apply tot his job Apply To this Job