Workers Comp/MVA Claims Specialist

Houston, TX 77001

Posted: 10/22/18 Industry: Healthcare Job Number: 00002T6M Pay Rate: 15.00 - 16.00
The Insurance Reimbursement Specialist is responsible for the collections of insurance claims pertaining to Worker's Compensation along with Motor Vehicle Accident claims. Essential to this position is the ability to manage all collection follow up for maximum insurance reimbursement. To include outbound and inbound insurance carrier calls, reprocessing claims, working denials and resolving unpaid claims. Calling attorney's office, completing deposition questionnaire's, along with medical record retrieval experience a must!
Understanding and staying informed of the changes with procedures, billing guidelines, and laws for specific insurance carries or payers.
Initiating collection follow-up on all unpaid or denied claims with appropriate insurance carrier.
Research, and resolve unpaid insurance claims.
Actively follow up and collect on all claims, including resolution of any billing errors assigned following established procedures.
Follow up with attorney office on unpaid claims.
Respond to correspondence from insurance carries.
Perform other duties as assigned by department manager. WORKING CONDITIONS
Minimum Education: High School Diploma/G.E.D.
Minimum 3+ Years of experience with worker's comp follow up and motor vehicle accident collections.
Strong communications skills in both oral and written.
Positive attitude, Team player, "Go-getter".
Ability to have a productive phone conversations with the insurances companies and attorney's representative.
Understands the difference between 1st and 3rd party claims.
Demonstrates excellent problem solving skills and negotiating skills.
Knowledge of CMR, EPower and Centricity desired.
Understands the TMB guidelines for Medical Record retrieval.
Fully compliant with HIPPA a must!
Familiarity with computer and Windows PC applications such as Excel and Word, which includes the ability to learn new computer systems applications.

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