Job Description

Job Description

Job Description

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

Company Description

Synergy Health Partners is a healthcare management organization at the forefront of patient care. We work with our physicians, nurses, and other clinical staff to maintain the highest quality of care centered on patient-focused outcomes. With respect for the person and their health as the driving mindset behind our practice, we aim to provide cutting-edge compassionate treatment to each and every one of our patients. We partner with healthcare practices large and small and use over forty years of experience in medicine in the Metro Detroit area to ensure peace of mind to all of those in our care.

Synergy Health Partners is an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.

Company Description

Synergy Health Partners is a healthcare management organization at the forefront of patient care. We work with our physicians, nurses, and other clinical staff to maintain the highest quality of care centered on patient-focused outcomes. With respect for the person and their health as the driving mindset behind our practice, we aim to provide cutting-edge compassionate treatment to each and every one of our patients. We partner with healthcare practices large and small and use over forty years of experience in medicine in the Metro Detroit area to ensure peace of mind to all of those in our care.\r\n\r\nSynergy Health Partners is an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.

Job Tags

Full time, Private practice, Work at office, Remote work, Shift work

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