Workers’ Compensation Medical Billing Specialist

Redefine Healthcare specializes in continuity of care for patients, offering services from Neurosurgeons, Interventional Pain Management Specialists, Orthopedists, Psychiatrists, Physical Therapists, Chiropractors, and now Vascular specialists. We are seeking a dedicated, full-time Workers’ Compensation Medical Billing Specialist to join our team in Matawan.

About the role

This position manages the billing and collection process for Workers’ Compensation claims, ensuring accurate claim submission, payment posting, and follow-up with insurance carriers, third-party administrators, and adjusters to resolve outstanding balances or denied claims.

Responsibilities

• Process and submit medical claims related to Workers’ Compensation cases accurately and in a timely manner.
• Review patient accounts to ensure all Workers’ Compensation claim information (claim number, employer, insurance carrier, and adjuster details) is accurate and complete.
• Follow up with insurance carriers, third-party administrators (TPAs), and adjusters regarding claim status, payments, and denials.
• Investigate and resolve denied or unpaid Workers’ Compensation claims, ensuring proper documentation and resubmission when necessary.
• Communicate with patients, employers, insurance carriers, and adjusters regarding billing inquiries and claim updates.
• Ensure billing practices comply with Workers’ Compensation fee schedules, regulations, and payer guidelines.
• Post payments and adjustments accurately and reconcile accounts as needed.
• Maintain organized documentation for Workers’ Compensation claims and related correspondence.
• Work collaboratively with providers, front desk staff, and management to ensure accurate claim submission and timely reimbursement.
• Perform ad-hoc responsibilities and duties as assigned.

Requirements

• Proven experience in Workers’ Compensation medical billing or healthcare billing with Workers’ Compensation claims.
• Knowledge of Workers’ Compensation claim processes, insurance carriers, and fee schedules.
• Experience working with adjusters, employers, and third-party administrators (TPAs).
• Strong communication and problem-solving skills with the ability to professionally manage billing inquiries and claim issues.
• Strong attention to detail and ability to manage multiple claims and follow-ups efficiently.

Benefits

• Paid time off and sick time.
• Health insurance (medical, dental, vision, accident, and critical illness).
• Life insurance.
• 401(k) with Company match.
• Yearly bonus.

Pay

$21–25/hour, depending on specialty and experience.

Schedule

40 hours per week, full-time.