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Workers' Compensation Specialist at ORTHOLONESTAR
Houston, Texas, United States -
Full Time

Start Date

Immediate

Expiry Date

24 Mar, 26

Salary

0.0

Posted On

24 Dec, 25

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

No

Skills

Workers' Compensation, Medical Billing, Auditing, Claims Processing, Communication, Problem Solving, Attention to Detail, Computer Skills

Industry

Medical Practices

Description
Job Details Job Location: Houston, TX 77030 General Job Description Handles verification of injury/claim of all WC patients including auditing medical record for billing accuracy. Responsible for marketing to employers/WC clinics and is the point of contact for adjustors and case managers. ESSENTIAL FUNCTIONS Call adjustors to verify all new and established WC injuries/claims per protocol Audit WC appointments for comments/authorization/DWC Prepare claims and documentation for filing Point of contact for all adjustors and case managers Facilitate physician’s use and understanding of ODG Prepare DWC 73’s & 69’s Authorization of all 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. All 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 perform tedious and exacting work in frustrating conditions.
Responsibilities
The Workers' Compensation Specialist handles the verification of injury claims for WC patients and audits medical records for billing accuracy. They serve as the point of contact for adjustors and case managers while preparing claims and documentation for filing.