Occupational Medicine Coordinator - (3147) - Full-Time

Job Summary:

The Occupational Medicine Coordinator is responsible for managing the accounts receivables and billing processes for occupational health services provided to contracted employers. This role ensures accurate invoicing, timely payment collection, and reconciliation of accounts related to pre-employment screenings, workplace injury treatments, and other occupational health services. The coordinator serves as the primary billing point of contact for employer accounts, addressing billing inquiries, resolving discrepancies, and maintaining strong relationships with clients to facilitate prompt payments. Additionally, this role collaborates with internal departments to ensure proper documentation, contract compliance, and adherence to financial policies and regulatory guidelines.

Essential Duties/Responsibilities:

• Prepare, review, and submit claims or invoices for occupational medicine services, including workers’ compensation, employer-paid services, and third-party payers.
• Ensure codes included on invoices and claims accurately reflect the services provided, to include custom billing codes, CPT, ICD-10, and HCPCS codes.
• Verify insurance eligibility and coverage as well as employer contract terms and authorized services to ensure accurate claim submission and compliance with agreements.
• Coordinate with employers, insurance carriers, and third-party administrators to facilitate billing and payment resolution.
• Track and follow up on outstanding balances to minimize aged receivables.

• Investigate and resolve billing discrepancies, coordinating with internal teams and employer representatives as needed.
• Request refunds or process corrections, as necessary.
• Ensure adherence to contractual agreements and State and Federal regulatory guidelines related to occupational health and workers’ compensation billing.
• Work closely with internal departments and contracted employers to ensure proper documentation, billing compliance, and prompt payment resolution.
• Stay updated on changes in billing regulations related to occupational medicine.
• Act as a liaison between employers, patients, insurance companies, and internal departments regarding billing inquiries.
• Provide detailed explanations of charges and payment responsibilities to employers and patients.

HIPAA, Security, and Privacy Requirements:

HIPAA Compliance

Ensure all Protected Health Information (PHI) is handled in accordance with the Health Insurance Portability and Accountability Act (HIPAA).

Maintain confidentiality of patient records, medical history, billing information, and other sensitive data.

Access, use, and share PHI only as necessary for billing and claims processing purposes.

Data Security

Follow organizational security protocols to safeguard electronic and paper-based patient information.

Ensure secure storage and transmission of PHI, including the use of encrypted systems or platforms approved by the organization.

Adhere to password management policies, two-factor authentication, and other security measures to protect access to the Practice Management and billing systems.

Privacy Protection

Maintain a strict “need to know” basis for accessing patient information.

Follow procedures to minimize unauthorized access to patient records, whether physically (in-office) or digitally (online systems).

Promptly report any security breaches or unauthorized access incidents to the appropriate department or compliance officer.

Documentation and Auditing

Accurately document all actions involving patient information to ensure a clear audit trail, including billing, claims processing, and collections activities.

Participate in regular audits and reviews of billing practices to verify compliance with HIPAA and security regulations.

Training and Continuing Education

Complete required HIPAA and security training as mandated by the organization.

Stay updated on changes in healthcare privacy laws, HIPAA regulations, and organizational policies regarding patient data security.

Incident Reporting

Recognize and report any potential privacy or security violations, including unauthorized access to PHI, data breaches, or suspicious activities, following the organization’s incident reporting procedures.

Other Duties:

Other duties as assigned.

Qualifications:

Strong understanding of medical billing and accounts receivables, particularly in occupational health and workers’ compensation cases.

Experience working with and ensuring billing accuracy with both custom billing codes as well as CPT/ICD-10/HCPCS codes.

Excellent communication and customer service skills for interacting with internal customers, employers, insurers, third-party administrators, and patients.

Proficiency in medical billing software and electronic invoicing.

Strong attention to detail and problem-solving skills to manage accounts receivables effectively.

Ability to work independently and collaborate with cross-functional teams.

Minimum of 2–3 years of experience in medical billing, workers’ compensation claims processing, or accounts receivables, preferably in an occupational health or employer-contracted services setting.

ADA Physical Demands:

Rarely (Less than .5 hrs/day) Occasionally (0.6 – 2.5 hrs/day) Frequently (2.6 – 5.5 hrs/day) Continuously (5.6 – 8.0 hrs/day)

Competencies

General Competencies

• 
  Customer Service
• Professionalism/Integrity/Responsibility
• Teamwork/Process Focus
• Dependability/Punctuality
• Interpersonal Relationships/Communication
• Judgment/Decision Making/Problem Solving
• Quality/Quantity
• Initiative
• Safety and Housekeeping
• Organizational Skills/Time Management
• Quality Management