Workers’ Compensation Medical Billing Specialist

Delaware Valley University

. Manage billing and accounts receivable for Pennsylvania Workers’ Compensation claims .

Posted 9/16/2026full-timeRemote • Florida • United StatesJuniorMid-LevelWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in Pennsylvania Workers’ Compensation billing processes, including managing accounts receivable, resolving claims, and maintaining accurate documentation. Proficient in collaborating with various stakeholders to ensure timely resolution of outstanding claims and adherence to performance expectations.

Highest-signal resume keywords

Pennsylvania Workers’ Compensation BillingClaims ResolutionEHR/Practice Management SystemsDenial ManagementHigh-Volume Claim Follow-Up

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Medical BillingCPT/HCPCS TerminologyICD-10 TerminologyAccounts Receivable ManagementClaims ResearchPayment ReconciliationDocumentation AccuracyBilling Requirements InterpretationReconsiderations and Appeals PreparationDiscrepancy Identification

Soft Skills

Attention to DetailOrganizational SkillsProfessional CommunicationProblem-SolvingPersistence

Tools & Technologies

Electronic Billing PlatformsEHR Systems

Industry Keywords

Workers’ CompensationInsurance CarriersThird-Party AdministratorsAdjustersNeurosurgeryOrthopedicsPain ManagementPhysical TherapySurgical ClaimsHigh-Dollar Claims

About the role

Key responsibilities & impact

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

What you’ll need

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

Comp & perks

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