Overview
Medical Biller: Workers’ Compensation Accounts Receivable (AR) Specialist Jobs in Troy at Southeastern Michigan Orthopedics and Pain Management Specialists, P.C.
The Workers’ Compensation Accounts Receivable (AR) Specialist is responsible for managing and collecting outstanding workers’ compensation claims and balances. This role focuses on timely follow-up, accurate posting of payments, denial resolution, and effective communication with payers, employers, and internal teams to ensure maximum reimbursement and compliance with workers’ compensation regulations.
Key Responsibilities
- Manage full-cycle accounts receivable for workers’ compensation claims
- Submit, review, and follow up on workers’ compensation claims to ensure timely payment
- Investigate and resolve claim denials, underpayments, and payment delays
- Post payments, adjustments, and contractual allowances accurately
- Communicate with insurance carriers, third-party administrators (TPAs), employers, and case managers regarding claim status
- Review Explanation of Benefits (EOBs) and Explanation of Review (EORs) for accuracy
- Appeal denied or reduced claims according to state workers’ compensation guidelines. This may include filing 104B forms and attending virtual mediation hearings.
- Supply attorneys with cost containment spreadsheet breakdowns
- Maintain accurate documentation and notes within billing and practice management systems
- Monitor aging reports and prioritize high-dollar or aged accounts
- Ensure compliance with state-specific workers’ compensation billing rules and cost containment rates
- Collaborate with billing, coding, and clinical teams to resolve claim discrepancies
- Provide reporting and status updates to management as requested
Required Qualifications
- High school diploma or equivalent (Associate’s degree preferred)
- 2+ years of experience in medical billing and accounts receivable, with a strong focus on workers’ compensation
- In-depth knowledge of workers’ compensation billing processes, cost containment rates, and regulations
- Experience working with insurance carriers, TPAs, and employer-based claims
- Proficiency with medical billing software and Microsoft Office (Excel, Word, Outlook)
- Strong analytical, organizational, and problem-solving skills
- Excellent verbal and written communication skills
- Ability to manage multiple accounts and meet deadlines in a fast-paced environment
Preferred Qualifications
- Experience with appeals and litigation-related workers’ compensation claims
- Familiarity with state-specific workers’ compensation systems and portals
Skills & Competencies
- Attention to detail and accuracy
- Persistence and strong follow-up skills
- Ability to interpret EOBs/EORs and fee schedules
- Time management and prioritization
- Professional and customer-service-oriented communication
Work Environment
- Hybrid: In office/remote
- Full-time position, standard business hours M-F.
- 8hr shift/no weekends
- Healthcare setting: Ambulatory surgery center, outpatient, and private practice
Medical Specialties:
- Orthopedics
- Pain Medicine
- Podiatry
- Chiropractic
- Physical Therapy
- Spine
- Sports Medicine
Pay: $18.00 – $25.00 per hour
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Employee assistance program
- Employee discount
- Flexible schedule
- Flexible spending account
- Health insurance
- Life insurance
- Paid time off
- Retirement plan
- Tuition reimbursement
- Vision insurance
Work Location: In person
Title: Medical Biller: Workers’ Compensation Accounts Receivable (AR) Specialist
Company: Southeastern Michigan Orthopedics and Pain Management Specialists, P.C.
Location: Troy
