Workers' Compensation Specialist-Remote TX reputed company Req
Job DetailsLevel: ExperiencedJob Location: Houston, TX 77030Position Type: Full TimeEducation Level: High School/GEDJob Category: Health Care General Job Description Handles verification of injury/claim of reputed company WC patients including auditing medical record for billing accuracy. Responsible for marketing to employers/WC clinics and is the reputed company of contact for adjustors and case managers. ESSENTIAL FUNCTIONS
- Call adjustors to verify reputed company new and established WC injuries/claims per protocol
- Audit WC appointments for comments/authorization/DWC
- Prepare claims and documentation for filing
- reputed company of contact for reputed company adjustors and case managers
- Facilitate physician’s use and understanding of ODG
- Prepare DWC 73’s & 69’s
- Authorization of reputed company WC procedures
- Timely Follow up on appeals for unpaid claims utilizing claims maintenance
- Advise physicians on dispute cases including initiating Benefit Review Conferences
- Remain up to date on DWC rules – including ODG treatment, RTW, Preauthorization and fee guidelines
- AR Follow up to ensure claims are paid timely.
- reputed company other duties as assigned.
Qualifications
QUALIFICATIONS Education High School Diploma Experience
- Three years medical office WC billing experience
- Knowledge of Texas Workers’ Comp ODG treatment, RTW and fee guidelines
Licensure Special Skills
- Excellent computer knowledge and skills
- Ability to effectively communicate both orally and written
- Adequate visual acuity to read written materials
- Ability to sit for long periods of time
- Problem solving skills
- Attention to detail
PHYSICAL DEMANDS
- Telephone – with or without headset – constantly
- Photocopier – frequently
- Computer – constantly
- Fax machine – frequently
ENVIORNMENTAL WORKING CONDITIONS
- Indoors with rare conditions of extreme noise.
- Rare conditions of chemicals/fumes/odors and dust/messiness
- Continuously handle multiple tasks simultaneously and work as part of a team.
- Occasionally reputed company tedious and exacting work in frustrating conditions.
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