Workers’ Compensation Medical Billing Specialist

Job not on LinkedIn

🔥 12 hours ago

🐊 Florida, New Jersey, +1 more states – Remote

🐊 Florida – Remote 🏖️ New Jersey – Remote 🔔 Pennsylvania – Remote

⏰ Full Time

🟢 Junior

🟡 Mid-level

🏥 Medical Billing and Coding

🚫👨‍🎓 No degree required

👻 Ghost score 10%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Delaware Valley University

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 1896

💼 Consulting

🏥 Healthcare

📚 Education

Consulting • Healthcare • Education

Delaware Valley University is a private university in Doylestown, Pennsylvania focused on experiential, career-oriented education with strong programs in agriculture, life sciences, and applied fields. The university emphasizes hands-on learning through its award-winning Experience360 program, offers undergraduate and graduate degrees (including a Master of Public Health), professional certificates, and strong employer connections that lead to high post-graduation career outcomes. DelVal also supports applied research and industry partnerships in areas like crop science, plant genetics, nutrition, and agricultural innovation.

📋 Description

• Manage billing and accounts receivable for Pennsylvania Workers’ Compensation claims • Perform consistent follow-up on outstanding, unpaid, and underpaid Workers’ Compensation claims • Communicate with insurance carriers, third-party administrators, adjusters, nurse case managers, and other claim representatives to resolve outstanding balances • Review payments and remittance documentation for accuracy and identify inappropriate reductions, denials, and underpayments • Research and resolve denied or rejected bills involving claim information, authorization, compensability, documentation, coding, and billing requirements • Prepare and submit reconsiderations, appeals, corrected bills, and supporting documentation • Identify discrepancies between billed charges, expected reimbursement, and actual payments • Maintain accurate account notes documenting collection activity and follow-up • Work Workers’ Compensation aging reports systematically and prioritize accounts requiring immediate action • Obtain and verify claim information, including carrier/TPA, adjuster information, claim numbers, dates of injury, and authorization information • Identify recurring denial and payment trends and escalate systemic issues to management • Collaborate with coding, authorization, clinical, and front-end teams to resolve reimbursement issues • Maintain consistent account follow-up and meet established productivity and A/R performance expectations

🎯 Requirements

• Must live in New Jersey, Pennsylvania, or Florida • Previous Pennsylvania Workers’ Compensation medical billing and/or A/R experience strongly preferred • Working knowledge of the Pennsylvania Workers’ Compensation billing process and fee schedule • Experience communicating with Workers’ Compensation carriers, TPAs, and adjusters • Experience researching and resolving denials, reductions, underpayments, and unpaid claims • Ability to interpret EOBs/EORs and determine the appropriate next step toward resolution • Familiarity with medical billing, CPT/HCPCS, and ICD-10 terminology • Experience using EHR/practice management systems and electronic billing platforms • Strong attention to detail and documentation skills • Persistent and comfortable with high-volume claim follow-up and collection activity • Ability to independently research problems and see accounts through to resolution • Must have a minimum of a high school diploma or equivalent • 2+ years of Pennsylvania Workers’ Compensation billing or collection experience preferred • Experience working Workers’ Compensation claims for a specialty medical practice preferred • Experience in neurosurgery, orthopedics, pain management, physical therapy, or other surgical/specialty care preferred • Experience handling high-dollar surgical or procedural claims preferred • Strong understanding of denial and underpayment trends and ability to identify root causes preferred • Strong organizational and prioritization skills preferred • Confident and professional communication skills with adjusters, carriers, TPAs, providers, and internal teams preferred • Experience managing a dedicated Workers’ Compensation A/R inventory from initial billing through final resolution preferred

🏖️ Benefits

• Full-time position • In-office, remote, or hybrid work arrangement • Equal opportunity employer • Diverse workplace at all levels of the organization