Workers Compensation Medical Billing  

Spring Valley, NY

$32/Hour

Medical billing for workers' compensation involves the process of submitting and managing claims related to medical services provided to employees who have suffered work-related injuries or illnesses. This specialized billing process ensures that healthcare providers are appropriately compensated for the treatment they deliver to workers covered by the workers' compensation insurance system. It involves accurate coding, documentation, and submission of claims to the relevant workers' compensation insurance carriers, facilitating the reimbursement of medical expenses incurred in the treatment of work-related health issues. 

Responsibilities:

1. Understanding Workers' Compensation Regulations: 

• Stay updated on workers' compensation regulations and guidelines to ensure accurate billing. 
• Familiarity with state-specific rules and regulations related to workers' compensation. 2. Patient Information Verification: 
• Verify and collect all necessary information related to the injured worker, including insurance details, employer information, and accident details. 

3. Insurance Claim Submission: 

• Prepare and submit workers' compensation insurance claims to the appropriate insurance carriers. 
• Ensure that all required documentation, such as medical reports and treatment plans, accompanies the claims. 

4. Coding and Documentation: 

• Assign appropriate medical codes (e.g., ICD-10, CPT, HCPCS) to diagnoses, procedures, and services related to workers' compensation cases. 
• Ensure accurate and detailed documentation to support the billing codes. 

5. Claims Follow-Up: 

• Monitor the status of workers' compensation claims and follow up with insurance carriers to facilitate timely reimbursement. 
• Address any issues or discrepancies in the claims to prevent delays.

6. Payment Processing: 

• Track and process payments received from workers' compensation insurance carriers. • Reconcile payments with billed amounts and address any discrepancies. 7. Denials and Appeals: 
• Handle claim denials and submit appeals when necessary. 
• Work closely with healthcare providers to gather additional information to support the appeal process. 

8. Communication: 

• Communicate with healthcare providers, insurance companies, and injured workers to address inquiries and resolve billing-related issues. 
• Provide clear and accurate information regarding billing and reimbursement.

9. Compliance: 

• Ensure compliance with all relevant healthcare laws and regulations, including HIPAA and workers' compensation laws. 
• Stay informed about changes in regulations that may impact workers' compensation billing practices. 

10. Reporting: 

• Generate and analyze reports related to workers' compensation billing, including claim status, reimbursement trends, and denial reasons.

Monday - Thursday 9:00 - 5:00

Friday - Winter 9:00 -12:00 / Summer 9:00 -1:00