Workers Compensation Billing Specialist

Breg, Inc.; Carlsbad (CA); On-site; USD 100,000 - 125,000; Full time

Job summary

An established industry player is seeking a Workers Compensation Billing Specialist to enhance patient outcomes through exceptional billing practices. In this dynamic role, you will review and process claims, ensuring accuracy and compliance with payer policies. You will collaborate with various stakeholders, resolve discrepancies, and support process improvements while embodying the company's commitment to innovation and quality. This is an excellent opportunity to join a forward-thinking team dedicated to making a meaningful impact in orthopedic solutions and patient care.

Benefits

Comprehensive Benefits

Paid Time Off (PTO)

Company-paid holidays

Opportunities for professional advancement

Commitment to Diversity & Inclusion

Qualifications

• 5+ years experience in Workers Compensation billing required.
• Advanced knowledge of billing processes and payer policies.
• Excellent verbal and written communication skills.

Responsibilities

• Review WC claims for eligibility and documentation.
• Resolve discrepancies for accurate and timely payments.
• Collaborate with cross-functional teams to drive excellence.

Skills

Workers Compensation billing

CPT coding

ICD-10 coding

HCPCS coding

Microsoft Excel

Microsoft Word

Interpersonal communication

Attention to detail

Education

High school diploma or equivalent

Tools

Electronic Medical Record (EMR)

Practice management technology

Job description

Join Our Team and Keep Moving Forward with Breg!

At Breg, we are dedicated to advancing orthopedic solutions that enhance the lives of patients and support healthcare professionals. As a leader in the orthopedic industry, we provide innovative products, consulting, technology, and services that help people move forward with confidence.

We are currently seeking a Workers Compensation Billing Specialist to join our team in Carlsbad, CA. If you thrive in a dynamic environment where innovation and impact go hand in hand, this is the opportunity for you.

Who You Are

You are a forward-thinking professional who values collaboration, innovation, and making a meaningful difference. You bring expertise in the ability to communicate effectively both written and verbally and are eager to contribute to a team that is committed to delivering exceptional patient outcomes.

What You’ll Do

As a Workers Compensation Billing Specialist, you will:

1. Review Workers Compensation (WC) claims to ensure eligibility, correct payer selection, proper documentation and authorization are met to achieve successful payment of claims, while providing exceptional customer service to patients, business partners, and customers.
2. Identify and resolve discrepancies, ensuring accurate and timely payments.
3. Work in conjunction with the Health Information Management (HIM) department to ensure accurate claim information is obtained.
4. Interact with insurance carriers, providers, adjusters, patients and internal stakeholders to finalize claims with missing information and address billing inquiries.
5. Proactively work to secure incomplete data for clean claim submission including utilizing Electronic Medical Record (EMR) access, payor portals, submitting traditional medical record requests and contacting payers, patients, providers, Sales Representatives, WC Adjuster and Employers.
6. Obtain authorization and pre-authorization as required.
7. Track outstanding balances, follow-up on payments/underpayments.
8. Research and resolve claim denials and rejections, working proactively to identify trends and implement corrective actions.
9. Assist and participate in process improvement activities as a Workers Compensation subject matter expert.
10. Use knowledge of standard medical terminology, basic human anatomy, and orthopedic diagnoses ICD-10 codes.
11. Meet daily, weekly, and monthly objectives including claim processing, revenue, and achievement of performance metrics.
12. Support all other medical billing and collection tasks as required.
13. Behave in a professional manner both internally and externally in relationships that positively impact the company's reputation and comply with the company's policies and practices.
14. Be accountable and committed to demonstrating Breg’s cultural beliefs and achieving the key results of the company.
15. Promote Breg's culture within the organization using established tools such as storytelling, providing focused feedback, and recognition. The performance of the position is aligned with the culture of commitment and accountability, following the steps of: See it, Own it, Solve it, and Do it.
16. Collaborate with cross-functional teams to drive excellence in patient care and business solutions.

What You Bring

1. High school diploma or equivalent required.
2. A minimum of 5+ years of experience in Workers Compensation billing required.
3. Advanced knowledge of Workers Compensation billing processes and payer policies for various states.
4. Detail-oriented with the ability to meet deadlines and manage multiple priorities.
5. Knowledge of CPT, ICD-10, and HCPCS coding and insurance billing rules.
6. Proficient in Microsoft Excel, Word, and electronic e-mail systems.
7. Proficient in computers and relevant software application and practice management technology.
8. Excellent organizational skills and ability to multitask.
9. Exhibit high level of quality through attention to detail and monitoring of work.
10. Excellent verbal and written communication skills, as well as exceptional interpersonal communication skills.
11. A passion for innovation and a commitment to Breg’s mission to Keep Moving Forward.

Why Breg?

At Breg, we invest in our people and culture. We offer:

1. Comprehensive Benefits: Medical, dental, vision, disability, and life insurance, effective the first of the month after hire.
2. Work-Life Balance: Paid Time Off (PTO) and company-paid holidays.
3. Growth & Development: Opportunities for professional advancement within a company that values your contributions.
4. Commitment to Diversity & Inclusion: Breg is proud to be an Equal Employment Opportunity employer, fostering a diverse and inclusive workplace.
5. For more information regarding Company benefits, please see https://www.breg.com/benefits

Work Schedules include….

1. May include variable start/end times outside of the company’s standard business hours of 8:00 a.m. – 5:00 p.m.

Compensation

Salary Range: $24.07-$30.96/hr. Actual compensation is determined by factors such as experience, skills, and business needs. This range reflects the minimum and maximum target range for new hire base salary/pay across all US locations. Actual pay is based on many factors unique to each candidate, including but not limited to geographical location, work experience, skill set, relevant trainings and certifications, and business needs. The base pay range is subject to change and may be modified in the future. This role may also be eligible for bonus.

Ready to Move Forward?

If you’re ready to be part of a company that is redefining orthopedic care, apply today at www.breg.com/careers.

Breg is an Equal Employment Opportunity Employer and dedicated to a diverse work force and Drug Free work environment. EOE/Minorities/Females/Vet/Disabled are encouraged to apply.

Applicants must be currently authorized to work in the United States on a full-time basis. The Company will not sponsor applicants for work visas for this position.

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