No- Fault & Workers' Compensation Collections Specialist

M&D Capital Premier Billing • Richmond Hill, NY

1d • $45,000 - $65,000

About The Position

We are seeking a No-Fault Insurance & Workers' Compensation Collections Specialist to join our Accounts Receivable Team. This position involves handling insurance denials, appeals, and rejections for high dollar surgical medical claims. This role requires knowledge of the healthcare industry, familiarity with insurance payer mix, and full claims life cycle.

Requirements

• Must have an understanding of No-Fault and Workers Compensation rules and regulations
• Strong attention to detail and organizational skills
• Effective communication skills, especially when working with insurance representatives
• Proficient in Microsoft Office applications
• High school diploma or equivalent
• Minimum of 2 years' experience with Workers Compensation and No Fault collections

Nice To Haves

• Experience with Epic EMR is a plus

Responsibilities

• Follow up with insurance companies on claim status, underpayments, and denials
• Resolve denied and underpaid claims promptly
• Review and interpret Explanation of Benefits (EOBs)
• Address and correct coding-related denials
• Use payer portals (e.g., Availity, Cigna, UHC, Navinet, Emblem) to check claim status
• Work with internal teams to resolve claim issues
• Access EMRs to obtain necessary medical records
• Post insurance payments and handle recoupments
• Generate and send patient statements
• Interpret terms for Workers' Compensation and No Fault when applicable

Benefits

• M&D Capital offers our employees a comprehensive benefits package, including health, dental, vision, employee assistance plan, paid family leave, short-term disability and life insurance.
• We also provide a 401(k) plan with employer match, flexible spending accounts, employee discount program and an employee referral program.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED