[Remote] Claims Billing Specialist I

Note: The job is a remote job and is open to candidates in USA. EMPLOYERS is a dynamic provider of workers' compensation insurance and services, seeking a Claims Billing Specialist I. This role involves reviewing and processing billing inquiries and medical bills, ensuring compliance with company policies and HIPAA, while maintaining efficient billing and claims operations.

Responsibilities

• Conduct business at all times with the highest standards of personal, professional, and ethical conduct
• Research and process provider billing inquiries, identifying discrepancies and applying standard resolution steps
• Review, calculate, then process in-house payments
• Review medical bills and accurately complete claims management system work items and assigned tasks
• Communicate with providers and internal staff to gather required documentation
• Review and respond to incoming mail, emails, telephone calls, and fax transmissions
• Maintain accurate documentation in claims systems
• Ensure all billing activities comply with company policies, regulatory requirements, and applicable standards (including HIPAA)
• Adhere to turnaround time parameters established by company policies and procedures
• Maintain confidentiality of all data and records in accordance with HIPAA and state regulations
• Participate in training to build knowledge of workers’ compensation billing and payment practices
• Perform special projects as assigned
• Other duties as assigned

Skills

• 1 - 3 years of experience in workers comp claims or medical billing
• Demonstrated skill in working independently within role responsibility while demonstrating multitasking skills, determining the relative importance of each, and completing assignments accordingly while maintaining a professional demeanor
• Excellent communication skills fostering a responsive customer service environment
• Excellent time management and organizational skills allowing for support of numerous levels in the operation
• Ability to understand statutes, regulations and company policies and procedures
• Must be detail-oriented with demonstrated ability to handle multiple tasks simultaneously
• Ability to demonstrate initiative and to meet designated deadlines
• Proficiency in MS Office Suite (Word, Excel, Outlook) and other relevant software tools
• Proven ability to handle sensitive and confidential information with discretion and professionalism
• Must have High School diploma or equivalent
• Some college preferred with experience and/or training in data management and paper media production

Benefits

• Comprehensive benefits package

Company Overview