Elevate Patient Financial Solutions® · 1 day ago
Workers Comp Claims Representative
United States
Full-time
Remote
Entry Level
$16/hr - $22/hr
1+ years exp
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Responsibilities
Maintain a queue of Workers’ Compensation accounts as assigned by management.
Maintain quality and productivity levels set by management once full job proficiency has been achieved.
Contact patient’s employer, Workers’ Compensation carrier, and injured worker via telephone and mail to obtain injury information and insurance information.
Support patients by answering any questions about the Workers’ Compensation process.
Coordinate with appropriate client personnel to ensure appropriate filing guidelines are met for reimbursement.
Request appropriate information, both verbally and written, from appropriate parties to ensure proper claim disposition.
Perform manual data entry of patient accounts and/or claim forms.
Submit hospital and physician bills to insurance companies for payment.
Maintain contact with insurance adjusters/carriers, employers, and patients during the claim adjudication process to ensure that the hospital and physician bills are paid timely and in full.
Obtain claim status and gather supporting documentation to submit appeals.
Make written or verbal appeals to payers on denied claims.
Provide strong customer service to clients and provide responses to client inquiries within 24 hours.
Provide detailed updates to Elevate PFS’s account management system and hospital/provider practice management system as account work is completed.
Assist in training both new and existing employees, which may include contributing specific training material.
Escalate complex, complicated, or challenging accounts to management to ensure accounts are progressing effectively.
Identify and discuss root cause issues with management.
Maintain and updates proper account documents in multiple systems.
Assist management with ad hoc inventory initiatives and other projects, as needed.
Review and manage patient accounts to ensure that proper documentation, payments, and necessary letters of authorization are entered correctly.
Maintain and adhere to compliance policies and procedures.
Other duties as assigned.
Qualification
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Required
High School Diploma or GED
Positive and encouraging attitude
Strong customer service background
Professional, accurate, clear, and concise communication, both verbal and written, including the ability to write routine business correspondence
Detailed and thorough
Adaptable
Organized and excel in time management. Ability to manage and move quickly and accurately through a large workload
Proven ability to be assertive in order to proactively resolve issues.
Demonstrated ability to organize and set priorities according to changing situations and demands
Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.
Required computer skills: must have experience with data entry and word processing, be capable of operating routine office equipment, possess a working knowledge of MS Office applications, and understand how to navigate through web-based applications
1-5 years of related experience in the field or in a related area such as: Medical billing and coding, Medical appeals, Claims Adjudication, Insurance, Workers’ Compensation, Legal work
Remote and Hybrid positions require a home internet connection that meets the company’s upload and download speed criteria
Preferred
Some college coursework preferred
Benefits
Medical, Dental & Vision Insurance
401K (100% match for the first 3% & 50% match for the next 2%)
15 days of PTO
7 paid Holidays
2 Floating holidays
1 Elevate Day (floating holiday)
Pet Insurance
Employee referral bonus program
Teamwork: We believe in teamwork and having fun together
Career Growth: Gain great experience to promote to higher roles
Company
Elevate Patient Financial Solutions®
Elevate Patient Financial Solutions® is a trusted partner who delivers superior RCM solutions to hospitals, health systems, and health providers nationwide.
1,001-5,000 employees
Funding
Current Stage
Late StageLeadership Team
Michael Shea
Chairman and Chief Executive Officer
Recent News
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