DescriptionTITLE: Medical Billing & Collections Representative (Personal Injury)
COMPANY: Progressive Billing
PAY RANGE: OPM Pay Grade 7 (Hourly)
FLSA Status: Non-Exempt
SUMMARY:
The Personal Injury Billing & Collections Representative is responsible for managing the complete lifecycle of personal injury medical accounts, including billing, lien management, attorney follow-up, settlement recovery, collections, and account reconciliation. This position serves as a primary point of contact for attorneys, law firms, insurance adjusters, patients, and healthcare providers to ensure timely reimbursement for injury-related medical services.
The Personal Injury Billing & Collections Representative monitors accounts from the initial date of treatment through settlement, payment resolution, or account closure. This role requires strong knowledge of personal injury billing processes, Letters of Protection (LOPs), medical liens, third-party liability claims, settlement negotiations, and attorney communications. The position works closely with internal billing, coding, and clinical teams to maximize reimbursement while maintaining compliance with company policies, HIPAA requirements, and applicable billing guidelines.
ESSENTIAL DUTIES AND RESPONSIBILITIES
Personal Injury Billing & Collections
- Monitor and follow up on outstanding personal injury accounts, liens, settlement balances, and third-party liability claims.
- Track personal injury cases from date of service through settlement, payment, or final account resolution.
- Ensure accurate billing of injury-related medical services, including orthopedic, neuro spine, pain management, chiropractic, podiatry, and surgical services.
- Submit itemized bills, medical records, narratives, treatment summaries, and supporting documentation to attorneys and insurance carriers as required.
- Maintain detailed account notes documenting communication, settlement status, payment commitments, and case developments.
- Identify and resolve barriers impacting reimbursement and account recovery.
Attorney & Lien Follow-Up
- Maintain regular communication with attorney offices regarding case status, settlement progress, lien balances, and payment expectations.
- Obtain, verify, and maintain Letters of Protection (LOPs), attorney representation agreements, lien documentation, and settlement records.
- Follow up on settled cases to ensure timely payment of outstanding medical balances.
- Review attorney reduction requests and escalate to management when appropriate.
- Negotiate approved lien reductions in accordance with company policies and management directives.
- Escalate delayed, disputed, or high-value accounts for leadership review.
Dispute Resolution & Negotiation
- Investigate unpaid, underpaid, denied, or disputed personal injury accounts.
- Review attorney disputes and provide supporting documentation to substantiate billed charges.
- Negotiate reimbursement with attorneys, liability carriers, and responsible parties when authorized.
- Identify issues impacting payment, including missing documentation, settlement delays, policy limitations, case dismissals, or disputed treatment.
- Collaborate with billing, coding, authorization, and clinical teams to resolve account discrepancies.
Patient Communication
- Communicate professionally with patients regarding personal injury balances, attorney representation, lien status, and billing-related questions.
- Explain financial responsibility when applicable.
- Assist patients in obtaining and providing attorney information, claim details, and supporting documentation.
- Maintain professionalism, confidentiality, and HIPAA compliance during all patient interactions.
Documentation & Reporting
- Maintain accurate records of collection activity, attorney correspondence, settlement updates, lien negotiations, payment activity, and account status.
- Generate reports related to outstanding personal injury balances, settled accounts pending payment, lien reductions, collection activity, and recovery trends.
- Track high-dollar accounts and provide regular status updates to management.
- Ensure all documentation complies with HIPAA, company policies, and applicable billing regulations.
Payment Posting & Reconciliation
- Review and reconcile payments received against outstanding personal injury balances.
- Identify discrepancies between expected settlement proceeds and payments received.
- Process approved adjustments, reductions, refunds, and write-offs according to company policy.
- Ensure accounts are accurately closed upon payment, approved reduction, settlement resolution, or write-off.
QUALIFICATIONS
- Minimum of three (3) to five (5) years of medical billing and collections experience required.
- Strong personal injury billing and collections experience required.
- Experience working with attorneys, medical liens, Letters of Protection (LOPs), settlement payments, and third-party liability claims required.
- Experience within Orthopedic, Neuro Spine, Pain Management, Chiropractic, Podiatry, or surgical specialties strongly preferred.
- Thorough understanding of CPT, ICD-10, HCPCS coding, Explanation of Benefits (EOBs), medical billing processes, and healthcare documentation.
- Experience managing high-balance accounts and negotiating payment resolutions.
- Proficiency with medical billing systems, electronic health records (EHR), claims management software, and account follow-up tools.
- Strong Microsoft Office skills, particularly Excel and Outlook.
- Ability to maintain detailed account documentation and organized records.
- Knowledge of HIPAA regulations and healthcare privacy standards.
- Excellent verbal and written communication skills.
- Ability to communicate professionally with attorneys, patients, insurance carriers, healthcare providers, and internal departments.
- Strong negotiation, collection, and conflict-resolution abilities.
- Ability to clearly explain balances, settlement expectations, lien obligations, and reimbursement processes.
- Comfortable handling high-volume outbound calls and attorney correspondence.
- Strong attention to detail and analytical problem-solving abilities.
- Ability to prioritize high-value and time-sensitive accounts.
- Ability to manage multiple cases, deadlines, and follow-up requirements simultaneously.
- Ability to work independently while collaborating effectively with cross-functional teams.
EDUCATION
- High School Diploma or equivalent required.
- Associate's or Bachelor's degree in Healthcare Administration, Business Administration, Legal Studies, or a related field preferred.
- Medical billing, coding, or healthcare collections certification preferred but not required.
WORK ENVIRONMENT
- Office-based position.
- Standard Monday through Friday business hours.
- Occasional overtime may be required to meet collection objectives, settlement deadlines, or operational needs.
- Collaborative team environment with opportunities for professional growth and advancement.
PHYSICAL REQUIREMENTS
- Prolonged periods of sitting and computer use.
- Frequent communication by phone, email, and electronic systems.
- Ability to review detailed account records and billing documentation.
- Ability to occasionally lift up to 15 pounds.
DOL / FLSA CLASSIFICATION AND JUSTIFICATION
Based on the duties described above, the Personal Injury Billing & Collections Representative position is appropriately classified as a non-exempt position under the Fair Labor Standards Act (FLSA). The primary responsibilities of this role involve performing billing, collections, lien management, attorney follow-up, settlement tracking, payment reconciliation, and account documentation activities within established company procedures and guidelines.
While the position requires specialized knowledge of personal injury billing processes, medical liens, Letters of Protection, settlement recovery, and attorney communications, the role primarily applies established policies and procedures rather than exercising independent discretion and judgment on matters of significance as defined under FLSA exemption criteria. The employee does not have authority to formulate company policy, make significant financial decisions on behalf of the organization, direct business operations, or independently negotiate contractual agreements outside approved company parameters.
Accordingly, this position meets the requirements for classification as a non-exempt, hourly position and is eligible for overtime compensation in accordance with applicable federal and state wage and hour laws.
The above is intended to describe the general content of and requirements for the performance of this job. It is not to be construed as an exhaustive statement of duties, responsibilities, or physical requirements. Nothing in this job description restricts management’s right to assign or reassign duties and responsibilities to this job at any time. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.
Pay: $28.59 - $37.17 per hour
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Retirement plan
Work Location: In person
