Workersâ Compensation Medical Biller
Workersâ Compensation Medical Biller
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Job Description
Georgia Spine & Orthopaedics a leading orthopedic practice dedicated to providing comprehensive musculoskeletal care is seeking a detail-oriented Workers Compensation Medical Biller to support our team!
The Workers Compensation Medical Biller will support our Georgia North Carolina and Surgery Center entities. This role is responsible for handling professional and facility billing (CMS-1500 & UB-04) from start to finish ensuring claims are submitted correctly and followed through until resolution. The ideal candidate will have a strong understanding of Workers Compensation guidelines denial management and appeals processes to maximize reimbursement.
WC Medical Billing Responsibilities:
- Prepare and submit accurate Workers Compensation claims for professional and facility services.
- Ensure claims comply with state-specific Workers Compensation fee schedules and payer requirements (GA NC and facility-specific).
- Transfer claims from Care Cloud EMR to Waystar for submission (professional and institutional).
- Conduct thorough follow-up on outstanding claims until an EOB is received payment denial non-payment or non-authorization.
- Review and analyze denial codes; take corrective actions such as rebilling or submitting appeals.
- Draft and submit appeals for denied or underpaid claims with supporting documentation.
- Update patient accounts and charts with claim status and carrier responses per the Explanation of Benefits (EOB).
- Communicate with adjusters case managers attorneys and employers to resolve claim issues.
- Track and follow up on aged claims to ensure timely reimbursement.
- Collaborate with intake and coding teams to ensure documentation accuracy before billing
Requirements:
- Experience in healthcare billing and workers Compensation processes.
- Basic understanding of medical terminology and billing concepts.
- Demonstrate ability to learn and apply ICD-10 and CPT coding.
- Willingness to be trained on Workers Compensation Fee schedules and regulations.
- Willingness to be trained in reviewing and challenging payment reduction and or denials.
- Commitment to providing excellent service to customers and patients.
- Ability to develop an understanding of Workers Compensation rules and forms including pre-certification prior authorization and provider changes.
- Developing collaboration teamwork and problem-solving skills to achieve team goals.
- Strong communication and listening skills with a willingness to improve
- Demonstrate eagerness to collaborate with Workers Compensation case managers attorneys insurance adjusters and employer groups to ensure client satisfaction and revenue optimizations.
Benefits & Perks
- Great benefits package including medical Dental vision and multiple add-ons available.
- 401(K)
- Paid time off
- Paid holidays
Employment Type
Full-Time
