Workers Compensation Biller

Summary

The Workers Compensation Biller is responsible for managing the billing processes for Workers' Compensation claims. This includes ensuring the accurate and timely submission of claims, resolving billing discrepancies, and following up on unpaid or delayed claims. The role also involves reconciling payments, adjusting accounts, and ensuring compliance with insurance guidelines.

Expectations
? Maintain punctuality and adhere to the established work schedule.
? Provide consistent, proactive support to the Billing Department, addressing billing discrepancies and inquiries professionally
? Maintain open communication with supervisors and staff, addressing billing inquiries and concerns promptly.
? Maintain confidentiality and respect for information regarding patients and team members, adhering to company rules of confidentiality.
? Demonstrates awareness and compliance of the corporate and organizational mission and objective of Camarena Health to promote health care access for all members of the community.

DUTIES and RESPONSIBILITES

1.0 Focus On Workers' Compensation Biller

1 .1 Assists with accounts receivable tasks to ensure timely and accurate collection of payments, following company policies, practices, and procedures.

1.2 Handles escalated billing issues by communicating with customers, employers, insurance companies, third-party administrators, and labs to ensure resolution.

1.3 Manages rebill processing and prepares detailed correspondence for customers regarding billing discrepancies or inquiries.

1.4 Regularly reviews account aging reports to track outstanding balances and ensures timely collections by initiating follow-up actions.

1.5 Analyzes incoming documents, identifies discrepancies, and makes necessary adjustments to accounts to maintain accurate records.

1.6 Performs detailed payment reconciliations, matching incoming receipts with accounts to ensure accurate tracking of financial transactions.

1.7 Prepares and shares regular reports on accounts receivable, aging accounts, and overdue accounts with management and clients.

1.8 Negotiates repayment terms with clients on overdue accounts, working to create feasible payment plans while maintaining positive relationships.

1.9 Makes informed decisions about when to refer accounts to collections or write off balances, ensuring alignment with company policies.

1.10 Identifies when adjustments to accounts are appropriate, ensuring proper application and accurate account balances.

1.11 Resolves employer issues, including misapplied or missing payments, and works closely with internal teams to address concerns promptly.

1.12 Collaborates with clinics and healthcare providers to resolve billing issues, clarify invoice discrepancies, and secure necessary supporting documentation.

1.13 Monitors rebills for open balances and takes appropriate action to ensure payments are processed efficiently.

2.0 Focus On Filing

2.1 Responsible for efficient, timely filing and retrieval of billing documentation

2.2 Ensures that billing files are organized and accessible for quick retrieval.

3.0 Focus On Corporate Expectations/Standards

3.1 Attends and actively participates in all required meetings (team meetings, department meetings, employee staff meetings) and other activities as needed.

3.2 Attends workshops/seminars as necessary to increase skills and knowledge to provide effective support.

3.3 Works flexible or extended hours where necessary.

3.4 Demonstrates awareness of, and compliance with, organizational mission and objective of Camarena Health to provide health care access and support services for all members of the community.

3.5 Other work-related duties as assigned by supervisor; duties and responsibilities may be added, deleted, or changed at any time at the discretion of management, formally or informally either verbally or in writing.

3.6 Maintains confidentiality and respect for information regarding patients and other team members; abides by Camarena Health Rules of Confidentiality

Minimum Requirements

Education:
? High School Diploma or equivalent

Prior Experience
? Minimum two years? experience of demonstrated collection experience (occupational health, preferred)

Skills
? Fully Bilingual (English-Spanish).
? Effective oral and written skills.
? Telephone courtesy; customer-service oriented.
? Modern office practices and procedures including email.
? Familiarity with Microsoft Excel, Outlook, and Word.
? Ability to focus on the accuracy of financial data and identify discrepancies.
? Capable of prioritizing tasks and meeting deadlines in a fast-paced environment
? Strong ability to use logic to identify key facts, explore alternatives, and propose effective solutions.
? Outstanding interpersonal skills with the ability to deal tactfully and professionally with customers and clients.
? Strong written and verbal communication skills to convey information clearly and professionally.
? Ability to work independently with minimal supervision.
? Attention to detail and excellent follow-through on work tasks.
? Demonstrated good problem-solving skills; initiative and sound judgment.
? Able to quickly build and maintain rapport with patients and providers of differing backgrounds; team player.

Requirements

Physical Requirements: ? Must be able to move up to 20 pounds and push up to 50 pounds (on wheels). ? Must be able to hear staff on the phone and those who are served in-person, and speak clearly in order to communicate information to clients and staff. ? Must be able to have vision that is adequate to read memos, a computer screen, personnel forms and clinical and administrative documents. ? Must have average manual dexterity. ? Must be able to reach above the shoulder level to work, must be able to bend, squat and sit, stand, stoop, crouching, reaching, kneeling, twisting/turning.

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