Workers Comp, No Fault, Medical Biller

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Total Orthopedics and Sports Medicine is a leader in Long Island orthopedic care, dedicated to \'Getting You Back to You\' by providing exceptional orthopedic-specific services. Our state-of-the-art facilities offer immediate care for orthopedic injuries, ensuring patients receive timely treatment from highly awarded specialists.

We are seeking a detail-oriented and experienced Workers Compensation (WC) and No-Fault (NF) Medical Biller/Accounts Receivable (AR) Representative to join our healthcare billing team. The ideal candidate will be responsible for accurately billing and following up on WC/NF claims, ensuring timely reimbursement from insurance carriers and proper resolution of outstanding accounts.

Key Responsibilities

Billing & Claims Submission

Prepare, review, and submit WC/NF medical claims to insurance carriers in compliance with state and federal regulations.

Ensure all claims are coded correctly using appropriate ICD-10, CPT, and modifier codes.

Verify claim requirements based on jurisdictional and carrier-specific guidelines.

Accounts Receivable Management

Monitor aging reports and follow up on unpaid or denied claims in a timely manner.

Identify and resolve billing issues or payment discrepancies.

Resubmit or appeal denied/rejected claims as needed with proper documentation.

Patient & Provider Communication

Communicate with physicians, office staff, patients, and insurance companies regarding billing inquiries and claim statuses.

Provide updates and reporting to internal departments regarding claim progress and collections.

Documentation & Compliance

Maintain accurate and complete records of billing activity and correspondence.

Ensure compliance with HIPAA regulations and insurance guidelines.

Stay up to date on changes in WC/NF billing rules and regulations.

Qualifications

High school diploma or equivalent; associate degree or medical billing certification preferred.

2+ years of experience in medical billing, with a strong focus on Workers\' Compensation and No-Fault claims.

Knowledge of medical terminology, CPT/ICD-10 coding, and EOB interpretation.

Experience with EMR/EHR systems and billing software (e.g., eClinicalWorks, Kareo, AdvancedMD, etc.).

Strong understanding of WC/NF insurance processes, including claim timelines and legal documentation.

Excellent communication, problem-solving, and organizational skills.

Ability to work independently and collaboratively in a fast-paced environment.

Preferred Skills

Familiarity with state-specific WC/NF regulations (e.g., New York, New Jersey).

Experience in medical collections and appeals.

Knowledge of lien-based billing practices (if applicable).

Job Type: Full-time

Pay: $24.22 - $28.00 per hour

Expected hours: 40 per week

Benefits

401(k)

401(k) matching

Dental insurance

Flexible schedule

Health insurance

Life insurance

Paid time off

Vision insurance

Ability To Commute

Syosset, NY 11791 (Required)

Seniority level

  • Seniority level

    Entry level

Employment type

  • Employment type

    Full-time

Job function

  • Job function

    Administrative

  • Industries

    Hospitals and Health Care

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