Workers Compensation Account Specialist
Pay Range: $22.67-$27.00/hour (commensurate based on experience)
The Workers Compensation (WC) Account Specialist is responsible for managing workers’ compensation accounts, including securing required authorizations, coordinating with insurance adjusters, and ensuring timely claim processing. This role also performs accounts receivable follow-up with payers to resolve outstanding claims and support timely reimbursement.
What You’ll Do
- Secure required workers’ compensation authorizations through insurance portals or phone outreach
- Communicate authorization status, including approvals and denials, with providers and clinic staff
- Follow up with insurance carriers and adjusters to verify case details and resolve authorization or payment issues
- Perform accounts receivable follow-up to ensure timely claim resolution and reimbursement
- Monitor work queues to maintain productivity standards for authorizations and A/R follow-up
- Identify denial patterns, underpayments, or other claim issues and escalate when necessary
- Assist in resolving unpaid or unresolved claims with insurance payers
- Maintain compliance with HIPAA, OSHA, and internal risk management policies
- Participate in team meetings and training as needed
What We’re Looking For
- 2+ years of experience in medical billing or accounts receivable follow-up, preferably within workers’ compensation or denial management
- Understanding of clinic operations including patient registration, referrals, authorizations, and collections
- Familiarity with insurance payer reimbursement practices and claims processing
- Experience working with private, commercial, and government insurance claims
- Strong attention to detail and ability to manage multiple priorities
- Excellent communication and problem-solving skills
- Ability to maintain strict confidentiality of patient and organizational information
Benefits
- Rest, Reset & Recharge: Sick time in accordance with state and local requirements, plus 6 major holidays to unplug and focus on what matters most.
- Plan Ahead: Company-matched 401(k) to help you build what’s next, available once eligibility requirements are met (500+ hours in two consecutive years).
- Care for Your Crew: MetLife Pet Insurance with flexible plans, up to 90% reimbursement on eligible expenses, and 24/7 telehealth support via the PetMobile app.
- Play More, Pay Less: Exclusive savings through PlumBenefits and LifeMart on travel, hotels, theme parks, sporting events, shows, electronics, food delivery, and more.
Equal Opportunity Employer, including Disabled/Veterans.