Workers' Compensation Collections Representative

Job Overview
We are seeking a dedicated and detail-oriented Workers' Compensation Collections Representative to join our dynamic healthcare finance team. The ideal candidate will possess a strong understanding of the New York State collections processes, and workers' compensation insurance procedures. In this role, you will be responsible for managing the collection of outstanding balances related to workers' compensation claims, ensuring accurate and timely reimbursement while maintaining positive relationships with insurance carriers and healthcare providers. Your expertise in insurance regulations will be vital to optimizing revenue cycle operations and supporting our commitment to excellent financial management.

A Workers' Compensation Collections Representative is responsible for ensuring that the healthcare organization receives payments for services billed to workers' compensation insurance carriers.

Common duties include:

• Reviewing and following up on unpaid or underpaid workers' compensation claims
• Contacting insurance adjusters, employers, attorneys, and third-party administrators regarding claim status
• Investigating claim denials and payment discrepancies
• Submitting appeals, corrected claims, and supporting documentation
• Maintaining accurate account records and collection notes
• Monitoring aging reports and prioritizing overdue accounts
• Ensuring compliance with workers' compensation regulations and billing requirements

Typical qualifications:

• Experience in medical collections, or revenue cycle management
• Knowledge of workers' compensation claims processing
• Strong communication, negotiation, and problem-solving skills
• Attention to detail and organizational ability

Core Responsibilities/Duties

• Review and analyze workers' compensation claims to determine appropriate billing and coding procedures.
• Utilize medical treatment guidelines to ensure accurate claim reimbursement.
• Contact insurance carriers and third-party payers to follow up on outstanding payments and resolve claim discrepancies.
• Maintain detailed records of collection efforts within the Electronic Medical Record (EMR) systems.
• Collaborate with medical office staff to verify medical records, documentation, and billing information necessary for claims processing.
• Apply effective collection strategies while adhering to compliance standards related to medical billing and insurance regulations.
• Stay informed about updates in workers’ compensation policies, Medical Treatment Guideline changes, and relevant legal requirements affecting collections.
• Consistently delivering collections benchmarks

Pay: $23.00 - $28.00 per hour

Benefits:

• 401(k)
• Dental insurance
• Employee assistance program
• Employee discount
• Flexible schedule
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Parental leave
• Professional development assistance
• Referral program
• Retirement plan
• Vision insurance

Application Question(s):

• Desired Hourly Rate?

Experience:

• Workers' compensation Collections : 2 years (Required)
• Insurance follow-up/Denial Management: 2 years (Required)

Location:

• New York, NY 10005 (Preferred)

Shift availability:

• Day Shift (Required)

Ability to Commute:

• New York, NY 10005 (Required)

Work Location: In person