Workers' Compensation Appeals Specialist
Job Summary
Resolving post-payment disputes related to Workers' Compensation bills, the full-time remote Workers' Compensation Appeals Specialist will manage a caseload, conduct provider outreach, negotiate disputed charges, and ensure compliance with state regulations.
Key responsibilities
- Manage a caseload of post-payment Workers' Compensation bills, including state balance billing and usual and customary rate disputes
- Conduct proactive outreach to medical providers to negotiate reductions and resolve billing disputes
- Document all provider communications and adhere to state-specific compliance standards, including HIPAA
Required qualifications
- 2-3 years of relevant experience in Workers' Compensation bills, medical billing, or insurance negotiations
- Strong understanding of Workers' Compensation reimbursement methodologies and state regulations
- Experience negotiating medical bill payments or adjustments with providers
- Familiarity with claims processing systems and provider communications
- Ability to collaborate effectively with various stakeholders
Complete Job Description
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