No Fault/Liens Arbitration Specialist

CitiMed is a unique medical facility that provides exclusive healthcare amenities to our community. The range of medical and rehabilitative services offered has been specifically selected to treat traumatic injury patients. We provide a variety of health services including diagnostic and rehabilitation. Our vision directs the evolution of our practice, as we strive to improve our services to the community. All CitiMed offices are multilingual and staffed with individuals to make any experience pleasant. You can learn more about us at https://www.citimedny.com/.

Job Description:

The No Fault/Liens claims associate is responsible for the independent, prompt, and efficient evaluation, investigation, and resolution of assigned claims in accordance with legal statutes, policy provisions, and company guidelines to achieve positive results. Through effective investigation, coordination of medical care, negotiation, and interaction with clients, claimants, medical professionals, attorneys, and insurers ensure that the most advantageous outcomes are achieved, and client resources are utilized in a cost-effective manner. This position also provides technical expertise and serves as an advocate on client claim issues. Reporting to the No Fault/Liens A/R Manager, this position will be a key leader in the success of CitiMed’s future.

Detailed Responsibilities:

• The No Fault/Liens Arbitration Specialist is responsible for the independent, prompt, and efficient evaluation, investigation, and resolution of assigned claims in accordance with legal statutes, policy provisions, and company guidelines to achieve positive results.

• Effectively and accurately identify, analyze, and bring to RESOLUTION of case issues by:

o Reviewing and understanding EOBs, their related terms pertaining to No Fault and Liens.

o Identifying insurance coverage eligibility through examination of claims documentation and relate records.

o Resolving issues by collaborating with other departments to have bills and/or records corrected to prepare submission packets.

o If needed, contacting patients, treating offices, and attorneys to resolve claims.

o Reviewing and submit declaratory actions from court in order to submit to arbitrating attorneys for legal filings.

• Consistently, reconcile account balances and verify payments to ensure proper payment applications on claims.

• Review cases to determine arbitration eligibility. Adjudicate the claim effectively if arbitration is eligible based on department process guidelines.

• Coordinate with CitiMed arbitration attorneys for supplemental arbitration documents.

• Do not resort to only email communications with the necessary contacts if you are not successful in getting reimbursed, escalate your inquiry to a supervisor, contact the claim adjusters via the telephone and address the issue.

• Maintain a proper system of communication with the No Fault/Liens Claim Department & Verification Department, inform them about any cases you encounter that might require any update for billing purposes.

• Always maintain proper communication with the No Fault/Liens AR Manager in order to address any arising issues that you might not be able to resolve on your own.

• Maintain current knowledge of New York jurisdictional requirements and applicable case law.

• Maintain constant communication and if applicable, identify training areas with global resources to improve efficiency and accuracy.

Preferred Experience

· Minimum 2-5 years of No Fault/Liens billing experience

· Preferred Paralegal or any other No Fault legal experience

· Understanding of No-Fault regulations in NY

· Knowledge of HIPAA guidelines and compliance

We are looking for someone who is/can

· A Fast learner

· Experience with Microsoft Excel

· Detailed Oriented

· Work independently and efficiently

· Analyze and problem solve independently

· Has superb verbal and written communication skills

· Flexible and can adjust to different situations

· Work under pressure to meet productivity guidelines

Job Type: Full-time

Pay: $23.00 - $26.00 per hour

Benefits:

• Employee assistance program
• Health insurance
• Paid time off

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Experience:

• Paralegal experience: 1 year (Required)
• Microsoft Excel: 1 year (Required)
• HIPAA: 1 year (Required)
• No Fault/Liens billing: 2 years (Required)

Ability to Commute:

• Rego Park, NY 11374 (Required)

Work Location: In person

Salary : $23 - $26