Billing Associate

Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It’s an opportunity to do something meaningful, each and every day. It’s having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive.

A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you’re someone who cares, there’s a place for you here. Join us and contribute to Sedgwick being a great place to work.

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Billing Associate

PRIMARY PURPOSE : To review provider billing to ensuring appropriate healthcare common procedure coding (HCPC) / current procedural terminology (CPT) codes are applied. To ensure the accuracy and timely submission of client billing so that Sedgwick is paid correctly.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

Reviews provider charges/bills per authorized amount/limit and in line with contracted rates and payment terms.

Approves charges/bills for payment, then forwards them to the accounts payable team to issue payment and generates the explanation of review (EOR).

Collects necessary information to resolve payment status inquiries.

Assists with IT initiatives to improve processes and efficiency in a paperless environment.

Acts as a liaison for accounts receivable and accounts payables.

Resolves provider appeals.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

Performs other duties as assigned.

Supports the organizations quality program(s).

Travels as required.

QUALIFICATIONS

Education & Licensing

High school diploma or GED required.

Experience

Two (2) years of workers compensation billing experience or equivalent combination of education and experience required.

Skills & Knowledge

Basic understanding of revenue cycle management

Knowledge of workers compensation state fee schedules

Knowledge of ancillary healthcare network and provider contracts

Understanding of HCPC/CPT codes and various forms such as DWC10, UB04 and HCFA

Knowledge of various state by state billing regulations specific to workers compensation

Ability to meet KPI metrics

Excellent oral and written communication skills, including presentation skills

PC literate, including Microsoft Office products

Analytical and interpretive skills

Strong organizational skills

Excellent interpersonal skills

Ability to work in a team environment

Ability to meet or exceed Performance Competencies

WORK ENVIRONMENT

When applicable and appropriate, consideration will be given to reasonable accommodations.

Mental : Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines

Physical : Computer keyboarding, travel as required

Auditory/Visual : Hearing, vision and talking

NOTE : Credit security clearance, confirmed via a background credit check, is required for this position.

The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

If youre excited about this role but your experience doesnt align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.

Taking care of people is at the heart of everything we do. Caring counts

Sedgwick is a leading global provider of technology-enabled risk, benefits and integrated business solutions. Every day, in every time zone, the most well-known and respected organizations place their trust in us to help their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more than 30,000 colleagues across 80 countries embrace our shared purpose and values as they demonstrate what it means to work for an organization committed to doing the right thing – one where caring counts. Watch this video to learn more about us. (https://www.youtube.com/watch?v=ywxedjBGSfA)