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    Medical Lien Case Specialist

    Pouya Mohajer M D Ltd
    2-3 years
    $17 to $22 per hour
    Remote, USA
    10 Oct. 25, 2024
    Job Description
    Job Type: Full Time Education: B.Sc./ M.Sc./ M.Pharm/ B.Pharm/ Life Sciences Skills: Causality Assessment, Clinical SAS Programming, Communication Skills, CPC Certified, GCP guidelines, ICD-10 CM Codes, CPT-Codes, HCPCS Codes, ICD-10 CM, CPT, HCPCS Coding, ICH guidelines, ICSR Case Processing, Interpersonal Skill, Labelling Assessment, MedDRA Coding, Medical Billing, Medical Coding, Medical Terminology, Narrative Writing, Research & Development, Technical Skill, Triage of ICSRs, WHO DD Coding

    Position Summary

    The Medical Lien Case Specialist is responsible for managing and processing medical liens associated with personal injury and workers' compensation cases. This role involves coordinating with healthcare providers, attorneys, and insurance companies to ensure accurate processing of medical bills, notes, and related documentation. The Specialist will handle all aspects of lien management, from initiation to settlement, ensuring compliance with legal and billing standards while optimizing the collection of outstanding liens.

    Key Responsibilities

    Medical Lien Management:

    • Oversee all aspects of medical lien case processing, including creating, tracking, and resolving medical liens.
    • Communicate regularly with attorneys, insurance adjusters, and medical providers to ensure liens are handled appropriately and on time.
    • Manage the submission of medical liens and related documentation, ensuring claims are correctly filed and follow legal requirements.

    Billing and Documentation:

    • Process medical billing associated with lien cases, ensuring accuracy and adherence to medical coding and legal standards.
    • Review, prepare, and organize patient medical notes and records to support billing and lien claims.
    • Maintain up-to-date and accurate patient records, ensuring all necessary documentation is on file to support medical lien claims.

    Lien Negotiations and Settlements:

    • Collaborate with attorneys and insurance companies to negotiate settlements or reductions of liens as necessary.
    • Track and follow up on outstanding liens to ensure timely collection and settlement.
    • Ensure compliance with state and federal regulations regarding lien settlements and billing practices.

    Communication and Coordination:

    • Serve as the primary point of contact for attorneys, patients, and insurance companies regarding lien status, settlements, and case updates.
    • Coordinate with internal departments, such as the medical billing team, to ensure lien cases are processed accurately and efficiently.

    Reporting and Compliance:

    • Prepare and maintain reports on the status of medical liens, including outstanding balances and expected settlements.
    • Ensure compliance with HIPAA, state, and federal laws governing medical billing and lien cases.

    Qualifications

    Education:

    • High school diploma or equivalent required; associate's degree in healthcare administration, business, or related field preferred.

    Experience:

    • Minimum of 2-3 years of experience in medical billing, lien case management, or a related field.
    • Experience with personal injury and workers' compensation cases is highly preferred.

    Skills:

    • Strong knowledge of medical billing procedures, medical terminology, and legal aspects of lien management.
    • Excellent communication and negotiation skills, with the ability to work effectively with attorneys, insurance companies, and medical staff.
    • Proficient in medical billing software and Microsoft Office Suite (Word, Excel).
    • Strong organizational skills with the ability to handle multiple cases simultaneously and meet deadlines.

    Certifications (Preferred):

    • Certified Medical Reimbursement Specialist (CMRS) or similar certification.
    • Certification in Medical Billing and Coding (CPC or CBCS).

    Working Conditions

    • Office-based with occasional need for remote coordination.
    • Ability to work in a fast-paced environment with tight deadlines.

    Compensation

    • Competitive salary based on experience.
    • Benefits package including medical, dental, vision, and retirement plan options.

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