WORKERS' COMPENSATION / NO FAULT MEDICAL BILLER at Slocum-Dickson Medical Group, PLLC – New Hartford, New York

JOB SUMMARY: Under the Supervision of the Revenue Cycle Manager is responsible for managing the full billing cycle for work related and no fault injuries, ensuring accurate submission of claims to insurance carriers, employers, or state boards. Responsible for pursuing outstanding accounts and resolving denials to maximize reimbursement while adhering to regulations and HIPAA compliance.

DUTIES & RESPONSIBILITIES:

1. Prepare, review, and submit claims to workers’ compensation/No Fault, ensuring accurate carrier/claim information.

2. Responsible for aggressive follow–up of unpaid/denied claims through the use of payer web sites, portals, and other mechanisms as directed by management.

3. Responsible for specific Worker’s Compensation and No Fault payer rules, guidelines and billing procedures in order to accomplish follow-up activity.

4. Responsible for review and correction of denied claims in accordance with Federal and payer specific rules and regulations.

5. Responsible to call patients and employers to obtain full Worker’s Compensation or No Fault case information for timely claim submission.

6. Ensure all claims are worked within 48-72 hours of receipt.

7. Will assist in answering patient inquiries as needed.

8. Performs other office duties as assigned.

9. Attends meetings as requested.

10. Works overtime when required.

11. Adheres to the policies and procedures of SDMG including incident reporting.

12. Attends all required in-service programs and employee informational meetings.

13. Complies with established SDMG attendance policy.

14. Provides proper notification for absences and scheduled time off in accordance with SDMG policy

15. Knowledgeable of individual responsibilities and duties pertaining to SDMG safety/emergency preparedness including emergency codes.

16. Demonstrates knowledge of proper body mechanics to be used in the work setting.

17. May be exposed to hazardous drugs.

18. Attends OSHA and annual training upon initial employee orientation and annually thereafter.

19. Other duties as assigned as determined by the needs of the Business Office.

RELATIONSHIP WITH OTHERS: Must interact well with providers, clinical staff as well as payer staff and the staff and management in the Business Office. Must exhibit a high degree of attention to detail. Ability to work productively as part of a team and maintain professional conduct with colleagues and patients.

EDUCATION/EXPERIENCE/KNOWLEDGE: High School Diploma or equivalent. Minimum 2 years’ experience in medical billing, specifically with workers’ compensation and no fault claims. Strong understanding of medical terminology, ICD 10, and state specific workers’ com fee schedules.

PYSICAL REQUIREMENTS: Requires sitting, standing, bending, and reaching. May require lifting up to 20 pounds. Requires manual dexterity sufficient to operate office equipment such as computer, fax, calculator, and telephone. Requires normal hearing and vision.