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Senior Workers' Compensation Analyst
Harris ComputerCore Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in workers' compensation and No-Fault billing processes, including the ability to verify claims, negotiate with carriers, and mentor team members. Proficient in managing complex accounts and improving billing workflows to enhance reimbursement outcomes.
Highest-signal resume keywords
Workers' Compensation BillingNo-Fault BillingClaims ProcessingMentoring Team MembersNegotiation Skills
About the role
Key responsibilities & impact- Verify workers' compensation carrier and claim information before and during billing
- Confirm carrier, claim, injury, employer, adjuster, claim status, and accepted body-part details
- Obtain and document authorizations and referrals
- Contact carriers, adjusters, employers, and web portals regarding outstanding bills
- Prepare and submit accurate claims and correct errors
- Prepare and submit appeals with required documentation within filing deadlines
- Correct demographic and insurance information for billing
- Identify and report trends, recurring denials, and billing issues
- Improve workflows, reimbursement, and collection outcomes with leadership and management
- Create, update, and maintain SOPs for workers' compensation and No-Fault processes
- Mentor and train less-experienced team members as the workers' compensation and No-Fault billing expert
- Manage complex and escalated accounts through resolution
- Post payments and document payment records and issues
- Scan and upload documents and medical records for claims processing and medical records requests
Requirements
What you’ll need- Knowledge of orthopedic and pain management billing
- Knowledge of state workers' compensation guidelines
- Knowledge of major insurance carriers
- Ability to work workers' compensation and No-Fault accounts autonomously
- Ability to negotiate with carriers and adjusters
- Independent judgment within department policies
- Experience or capability to mentor and train less-experienced team members
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Claims SubmissionError CorrectionAuthorization DocumentationTrend IdentificationBilling Issue ReportingSOP CreationPayment PostingMedical Records ManagementInsurance Information CorrectionIndependent Judgment
Soft Skills
LeadershipAutonomous WorkCommunication
Tools & Technologies
Web PortalsBilling Software
Industry Keywords
Orthopedic BillingPain Management BillingState Workers' Compensation GuidelinesMajor Insurance Carriers