Bill Processor Level I

MedRisk LLC

22h • Onsite

About The Position

This position is responsible for reviewing and adjudicating complex medical bills and responding to inquiries from internal/external customers. Handles customer appeals and disputes of payments and pre-certifications within Horizon Casualty Services, Inc.

Requirements

• Requires High School diploma or GED equivalent.
• Requires a minimum of 2-3 years of experience adjudicating medical bills.
• Requires working knowledge of personal computers and supporting software in windows based environment including MS Office Products and email application systems.
• Requires knowledge of medical terminology.
• Requires knowledge of medical bill adjudication process.
• Requires knowledge of applicable laws and regulations regarding medical bill adjudication.
• Requires strong mathematical skills.
• Attention to Detail
• Decision Making
• Communication & Organizational Skills
• Flexibility/Adaptability
• Planning/Priority Setting
• Teamwork
• Applicants must live in PA or NJ for consideration with ability to commute to Newark, NJ approx. once a month for a team meeting.

Nice To Haves

• Prefers Bachelor's degree.
• Prefer work experience in a property and casualty insurance environment.
• Prefers knowledge of NJ Workers' Compensation and No-Fault laws.

Responsibilities

• Reviews and adjudicates complex medical bills in accordance with established policies and procedures.
• Posts approved bills for payment, and issues Explanation of Benefits (EOB) for denied payments.
• Responds to internal/external inquiries regarding the status of medical bills.
• Acts as information resource to Medical Consultants for policy determination.
• Assists in gathering/providing information for resolution of medical bill payment disputes and provider appeals.
• Completes other assigned functions as requested by Management.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED