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Worker's Comp Billing Coordinator - MIAMI MARLINS (Miami · FL)

MIAMI MARLINS jobs
Sports Jobs in Miami · FL
Human Resources: Human Resources/Benefits Administration
We are looking for talented team members that are driven, inclusive, innovative, passionate, and accountable to join our winning culture!

Essential Functions:
Work Comp Claims:
  • Open new claims when directed to by head of the medical department 
  • Keep records of all claims and bills submitted on Excel spreadsheet   
  • Follow up communication with physician offices, PT Clinics, pharmacies etc. and WC company 
  • Sending approval communication and claim #s to physician offices, surgery centers, etc. prior to appointments or surgery 
  • Liaison with workers compensation insurance broker consultant (The Fairly Group/Willis) and Club medical staff as necessary to ensure claims resolutions are tracked (i.e. monthly claims review) 
  • Participate in annual Workers’ Compensation Quality Council sponsored by MLB Risk Management to ensure ongoing development of training of regulatory matters and operational policies and procedures 

Team Pay: 
  • Must have competency with Florida Workers’ Compensation Health Care Provider Reimbursement manual in order to conduct manual re-pricing of medical provider billing
  • Any bills that should be paid by the team will need to be submitted and coded properly to finance
  • Keep a spreadsheet of all expenses paid – this tracker should list the billed amount and the allowed amount (paid) after re-pricing
  • Follow up communication with vendors and finance 

Insurance: 
  • Collecting/scanning insurance cards to be used for personal appointments and medications 

Medications
  • After a prescription is called in, the pharmacy needs to be called to verify if the medication should be billed to the team, personal insurance, or submitted to WC.  This is done under the direction of the head of the medical department. 
  • Receive delivery of medications/pick up medications from pharmacies 

Documentation: 
  • Keep an appointment spreadsheet 
  • Check that all doctor appointment, surgery notes, PT notes are obtained and in EMR 

Qualifications & Requirements
  • Four-year college degree
  • Must have 1-year of experience handling Worker's Comp claims

Selected candidate will be required to comply with The Miami Marlins Vaccination Policy. 

We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, national origin, sex, sexual orientation, age, disability, gender identity, marital or veteran status, or any other protected class.