Description

You will resolve post-payment disputes on Workers' Compensation bills by conducting provider outreach, negotiating charges, and ensuring state compliance. Your work directly supports cost containment and appropriate reimbursement.

Requirements

• 2–3 years experience in Workers' Compensation bills, medical billing, coding, or insurance negotiations
• Strong understanding of Workers' Compensation reimbursement methodologies and state regulations
• Experience negotiating medical bill payments or adjustments with providers
• Excellent communication, negotiation, and organizational skills
• Familiarity with claims processing systems

Responsibilities

• Manage caseload of post-payment Workers' Compensation bills, including state balance billing and UCR disputes
• Conduct provider outreach to explain payment methodologies, resolve disputes, and negotiate reductions
• Communicate with clients to coordinate and investigate case/appeal information
• Educate providers on Workers' Compensation billing and reimbursement policies
• Document all provider communications and adhere to state-specific compliance and confidentiality standards