Billing and Appeals Associate

We are seeking a detail-oriented and driven Workers’ Compensation Billing & Collections Specialist to manage end-to-end workers’ compensation and no-fault billing processes. This role plays a critical part in ensuring accurate claims submission, timely follow-ups, appeals management, and revenue cycle optimization.

The ideal candidate has strong experience in medical billing, workers’ compensation claims, insurance follow-ups, and appeals handling within a fast-paced healthcare environment.

Key Responsibilities

• Initiate contact with workers’ compensation insurance carriers, adjusters, and web portals regarding outstanding claims

• Prepare, submit, and follow up on workers’ compensation and no-fault claims

• Review and appeal denied claims with complete documentation

• Verify and correct insurance and patient demographic information

• Post payments accurately and document payment records in a timely manner

• Manage charge entry, A/R follow-up, collections, and settlement negotiations

• Draft written responses to address billing and collections issues

• Retrieve authorizations and referrals from insurance companies

• Scan, upload, and manage medical records for claims processing

• Stay current with state workers’ compensation guidelines

• Escalate billing trends or recurring issues to management

• Perform additional duties as assigned

Ideal Candidate Traits

• Detail-oriented with high accuracy in data entry

• Strong phone and interpersonal skills

• Ability to work independently while collaborating with team members

• Proactive, assertive, and results-driven

• Customer-focused and solution-oriented

• Adaptable and supportive of change

• Committed to ethical practices and continuous learning

Why Join Us?

• Work in a collaborative and supportive environment

• Opportunity to develop expertise in specialized medical billing

• High-impact role contributing to revenue optimization

• Professional growth and advancement opportunities

Originally posted on Himalayas