Senior Workers' Compensation Analyst

This is a fully remote position, open to applicants in Tennessee.

📋 Description

• Verify the details of workers' compensation carriers and claims prior to and during the billing process.

• Confirm the specifics of the carrier, claim, injury, employer, adjuster, claim status, and acknowledged body-part information.

• Acquire and document necessary authorizations and referrals.

• Reach out to carriers, adjusters, employers, and utilize web portals concerning outstanding invoices.

• Prepare and submit precise claims while rectifying any errors.

• Prepare and file appeals along with required documentation within designated deadlines.

• Amend demographic and insurance details for billing purposes.

• Identify and report trends, recurring denials, and issues related to billing.

• Collaborate with leadership and management to enhance workflows, reimbursement processes, and collection outcomes.

• Develop, update, and maintain standard operating procedures (SOPs) for workers' compensation and No-Fault processes.

• Mentor and train junior team members as the expert in workers' compensation and No-Fault billing.

• Manage complex and escalated accounts until resolution is achieved.

• Post payments and keep accurate records of payment histories and issues.

• Scan and upload documents and medical records for claims processing and requests related to medical records.

⛳️ Requirements

• Familiarity with orthopedic and pain management billing practices.

• Understanding of state workers' compensation regulations.

• Knowledge of major insurance providers.

• Capability to independently manage workers' compensation and No-Fault accounts.

• Proficiency in negotiating with carriers and adjusters.

• Ability to exercise independent judgment in accordance with departmental policies.

• Experience or capacity to mentor and train less-experienced team members.

🏝️ Benefits

• Comprehensive health and wellness benefits.

• Opportunities for professional development and growth.

• Supportive work environment with a focus on team collaboration.