About Us

At Excelsia Injury Care we provide management services to a host of healthcare companies throughout Maryland, Delaware, Virginia, Pennsylvania and Missouri which furnishes high-quality integrated healthcare to people suffering from neuro-musculoskeletal injuries. The healthcare companies we manage and service offer an extensive slate of office-based diagnostic, surgical and rehabilitation services, provided by compassionate and skilled professionals who medically manage each patient from evaluation through treatment to ensure patients have the best achievable outcomes. Our healthcare companies are leaders in care delivery for personal injury and worker's compensation patients and have a proven track record of returning patients to their highest level of activity as quickly as possible. We are devoted to furnishing highly competent and timely services in compliance with all applicable legal, regulatory and ethical standards; a commitment to doing things right. We strive to be a good corporate citizen and integrate ESG (environmental, social and governance) considerations within our Enterprise business practices. Our mission is to benefit the healthcare companies we serve, as well as all our collective employees, and communities.

Job Duties

Preparation of C-51 (claim for medical payment) packets

• An itemized bill must be prepared in compliance with COMAR 14.09.08.06 on a CMS 1500 form in the manner provided by the Workers' Compensation Commission and submitted to the Employer/Insurer for payment
• If payment is refused, the itemized bill (CMS1500) must be submitted with the WCC Claim for Medical Services Form C-51 including any relevant correspondence on the subject
  • Form C-51 must be completed in entirety
• CPT codes will be validated using the Medical Fee Guide for the year of service. Some CPT codes which are not "specific" may require a detailed description
• The Commission will issue an Order NISI for allowed medical claims per the Medical Fee Guide
  • To controvert the Order NISI complete the Workers' Compensation Commission form H-32 'Controversion of Medical Claim'

• The 'Controversion of Medical Claim' form must be filed with the Workers' Compensation Commission within 21 days of the date of the Order NISI and copies must be mailed to the Health Care Provider and other appropriate parties
• If the medical claim is controverted, it will be scheduled for a hearing before a Commissioner

• If the medical claim is not controverted, the Workers' Compensation Commission will issue a Final Order of Payment
  • A provider may request a hearing before the Commission if an insurer refuses payment of the Medical Claim after the Final Order of Payment
  • The Commission may impose penalties, fines and interest or may deny the Employer and Insurer the right to object to reimbursement if the Insurer fails without good cause to timely reimburse the provider for treatment or services. (LE 9-664); COMAR 14.09.08.06F

Collecting

• Review the unpaid accounts that meet the criteria for filing C-51 form (including utilization of Artiva and/or specialized projects)
• Review accounts in all databases (where applicable) for accuracy
• Resubmit claims if necessary
• Forward the following adjustments /corrections to the designated employees at the BSO: write offs, payment adjustments, refunds, etc
• Assist attorneys, adjustors, and patients with account information and billing questions Obtain billing information if missing
• Work A/R correspondence
• Keep AR pools in Artiva current
• Complete daily A/R log
• Other duties as assigned by the management

Minimum Requirements

• High school diploma or GED equivalent
• Working knowledge of workers' compensations laws and regulations, insurance billing and collection procedures

Additional Skills/Competencies

• Excellent verbal and written communication skills
• Knowledge of computer applications, including Windows, Outlook, and Microsoft Office
• Problem solving and organizational skills
• Typing - 50 WPM
• Knowledge of insurance plans, workers' compensation, and personal injury
• Ability to effectively interact with doctors, attorneys, patients, and co-workers

Physical/Mental Requirements

Sitting, standing, walking, reaching above shoulder length, working with body bent over at waist, working in kneeling position, climbing stairs, climbing ladders, working with arms extended at shoulder length, lifting maximum of 20 lbs.

Diversity Statement

Excelsia Injury Care is an equal opportunity employer. We commit to a policy of nondiscrimination and equal opportunity for all employees and qualified applicants without regard to race, color, religion, creed, gender, pregnancy or related medical conditions, age, national origin or ancestry, physical or mental disability, genetic predisposition, marital, civil union or partnership status, sexual orientation, gender identity, or any other consideration protected by federal, state or local laws.