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Workers Compensation Claims Specialist
2 months ago
The WC ROC/RORS Insurance Representative plays a crucial role in ensuring timely reimbursement of claims. As a liaison between adjusters, insurance carriers, and case managers, this individual is responsible for guaranteeing all claims are reimbursed in a timely manner.
Key Responsibilities- Conduct investigations of rejected/denied claims to ensure timely follow-up and reimbursement.
- Serve as a liaison with adjusters, insurance carriers, and case managers to facilitate reimbursement.
- Requires two or more years' experience in medical insurance and billing in a clinic environment.
- Knowledge of Worker Comp processes and guidelines, including ICD-10, HCPCS CPT coding, and claim processes.
- Experience with insurance software programs such as GE Centricity and basic computer programs.
- Excellent problem-solving skills, attention to detail, and organization skills required.
- Ability to exercise good judgment and discretion, as well as time management skills.
- Effective verbal and phone communication skills.
- Coding certification preferred but not required.
- Must be a resident of the state of North Carolina.
- Ability to commute on site within the Raleigh/Research Triangle area as required.
$19-$25/hr.
