PRIME Occupational Medicine's Mission : PRIME is committed to providing the highest quality medical care for a multitude of businesses through various methods of service. With clinics currently located throughout the Louisiana and Texas regions, PRIME serves the corporate and industrial sectors with 24/7 availability. Objectives of this role
- A highly organized and detail-oriented professional with extensive experience in medical workers' compensation billing and administrative clerical support. Proven ability to accurately process and submit claims to maximize reimbursement and ensure compliance with all applicable regulations.
Responsibilities:
- Accurately prepare and submit workers' compensation claims using appropriate forms and coding guidelines.
- Ensure accurate patient demographics, including employer details and injury information are captured before billing.
- Enters, reviews, and updates all cycle billing, codes, and account information; proofs and balances reports; estimates and makes manual adjustments to accounts as needed; prints bills to collect revenues; processes account service orders; audit of account accuracy; processes closing accounts for final payment.
- Monitor the status of submitted claims, follow up on outstanding bills, and address claim denials or rejections.
- Stay updated on state-specific workers' compensation regulations and billing guidelines to maintain compliance.
- Managing the status of accounts and balances and identifying inconsistencies.
- Reviewing open accounts for collection efforts.
- Making outbound collection calls in a professional manner while providing excellent customer service.
- Resolving client-billing problems, applying efficient customer service in a timely manner.
- Collecting customer payments in accordance with payment due dates.
- Identifying issues attributing to account delinquency and discussing them with management.
- Assists internal and external auditors in gathering information requested and provides research on the sample requested.
- Ensure all internal and external deadlines are met.
- May be required to work overtime and or holidays
- May be required to travel.
- Other duties as assigned.
Requirements Skills and qualifications
- Two (2) years of billing and coding experience in workers' compensation.
- Medical Billing and Coding degree or certification preferred.
- Proven experience with workers compensation submissions.
- Strong customer service experience required.
- Strong problem solving skills required.
- Ability to work independently, multi-task and set daily goals to meet deadlines.
- Resourceful mindset and strong attention to detail
- Knowledge of local, state and national laws and regulations related to workers' compensation billing and coding.
Physical Demands: Sitting for prolonged periods of time, lift, carry push, pull or otherwise move objects up to 30 pounds. Repetitive motion. Extensive use of computers and keyboard. Substantial movements (motions) of the wrists, hands, and/or fingers. The worker is required to have close visual acuity to perform an activity such as: preparing and analyzing data and figures; transcribing; viewing a computer terminal; extensive reading. Work is performed in an office environment and requires the ability to operate standard office equipment and keyboards. Must have the ability to lift and small carry parcels, packages and other items, to walk short distances, and drive a vehicle to deliver and pick up materials. Must have the ability to climb stairs daily. Mental Requirements: Learn new tasks, remember processes, maintain focus, complete tasks independently, make timely decisions in the context of a workflow, ability to communicate with employees and visitors, ability to complete tasks in situations that have a speed or productivity quota. Position Unit: Accounting - Non-Exempt: Hourly