Full Cycle Biller - Workers' Compensation Specialist

SPOONER•Scottsdale, AZ

92d•Onsite

About The Position

At Spooner, Arizona's largest physical therapy private practice, we are most proud of our culture of excellence that is founded on our core values. Spooner has been helping our communities achieve health through movement for over 30 years, and we continue to grow in size and expertise every year. If you are looking to join a company where you can build a career, Spooner is the place for you. Are you an outgoing and engaging individual committed to delivering exceptional customer service? Are you a natural communicator who enjoys communicating with diverse people? We encourage you to apply if you are ready to be at the forefront of customer service excellence! As the Medical Billing and Collections Specialist, you will serve as the communications hub between the company, patients, referring providers and payers. You will be responsible for analyzing claim denials, billing/collecting payments, and reviewing patient statements for accuracy. This role is vital in ensuring our clients and stakeholders receive the best possible experience.

Requirements

High school diploma or GED required.
2–3 years of experience in healthcare administration, medical billing, patient access, or revenue cycle operations.
Workers’ compensation and/or Medicaid billing experience strongly preferred.
Knowledge of insurance verification, authorizations, claims processing, appeals, and denial management.
Exceptional communication, multitasking, and customer service skills.
Strong attention to detail with the ability to navigate multiple systems and prioritize effectively in a high-volume environment.
Commitment to professionalism, accountability, and patient-centered service.

Responsibilities

Coordinate communication between patients, adjusters, nurse case managers, providers, employers, clearinghouses, and payers regarding eligibility, authorizations, treatment approvals, claims status, and denials.
Verify workers’ compensation coverage, medical benefits, claim details, and authorization requirements.
Manage inbound calls with professionalism, urgency, and exceptional customer service.
Obtain prior authorizations when necessary for evaluations, and therapy services based on a treatment plan.
Perform ongoing re-verification of benefits and claim eligibility for active workers’ compensation cases.
Run and analyze billing reports to proactively identify issues.
Process charge entry, coding review, and claims submissions with a strong focus on accuracy and regulatory compliance.
Investigate and resolve billing edits, rejected claims, and denied services while ensuring documentation supports all billed procedures.
Review patient accounts and insurance correspondence, including Explanation of Benefits (EOBs), to determine next-step resolution strategies and appeal opportunities.
Collaborate directly with insurance carriers, third-party administrators (TPAs), and workers’ compensation adjusters to monitor claim status and accelerate payment resolution.
Prepare detailed appeal documentation and build strong rebuttals for denied or underpaid claims.
Analyze denial trends and produce reporting that identifies key areas of concern by payer, volume, and financial impact.
Resolve assigned billing and account tasks promptly while contributing to a high-performing, patient-focused team environment.
Prepare an analytical summary report identifying areas of concern by dollar amount, volume and new denials.
Resolve tasks assigned to you and to billing.