Senior Workers' Comp Claims Specialist

Harris Computer; Tennessee; Ibrido; USD 70.000 - 100.000; Tempo pieno

Descrizione del lavoro

Harris Computer is seeking a Senior Workers' Compensation Specialist, Complex Claims, to verify WC carrier and claim information, manage billing, denials and appeals, and work autonomously on WC and No-Fault accounts. The role involves negotiating with carriers, adjusting with leaders to improve workflows, and mentoring teammates.

The ideal candidate understands orthopedic and pain management billing, state WC guidelines, and major insurance carriers.

Competenze

• Experience with workers' compensation and No-Fault billing.
• Knowledge of orthopedic and pain management billing, state WC guidelines and major insurance carriers.
• Ability to mentor and train team members and handle complex/escalated accounts.
• Ability to work autonomously and contribute to SOPs and workflow improvements.

Mansioni

• Verifies WC carrier and claim information during billing and posting.
• Obtains authorizations and referrals for scheduled services.
• Submits claims and prepares appeals within deadlines.
• Documents trends and denials to improve reimbursement and collections.
• Leads process improvements with leadership to streamline workflows.
• Mentors junior staff and serves as expert on WC and No-Fault billing.
• Posts payments and maintains payment records.

Conoscenze

Workers' compensation billing

No-Fault billing

Negotiation with carriers

Mentoring/leadership

Process improvement

Descrizione del lavoro

Harris Computer is seeking a Senior Workers' Compensation Specialist, Complex Claims, to verify WC carrier and claim information, manage billing, denials and appeals, and work autonomously on WC and No-Fault accounts. The role involves negotiating with carriers, adjusting with leaders to improve workflows, and mentoring teammates.

The ideal candidate understands orthopedic and pain management billing, state WC guidelines, and major insurance carriers.