Bill Review Specialist - Worker's Compensation

Paradigm • Tampa, FL

23h • $21 - $31 • Hybrid

About The Position

Paradigm is seeking a Bill Review Specialist to work in a hybrid position in its Tampa, Florida office. The role supports accurate and timely processing of workers’ compensation medical bills by reviewing billing documentation, researching payment issues, resolving discrepancies, and responding to billing inquiries. The specialist works closely with internal teams, providers, and clients to resolve issues and ensure billing accuracy and compliance. The ideal candidate is detail-oriented, analytical, comfortable working with medical billing information, and proactive in identifying and resolving inconsistencies.

Requirements

• High school diploma.
• At least 2 years of customer service experience.
• At least 2 years of workers’ compensation, healthcare, claims, and/or bill review experience.
• Intermediate computer experience using Microsoft Word, Excel, and Outlook.
• Excellent organizational skills.
• Excellent oral communication skills and phone presence, with the ability to present information effectively to providers and organizational employees.
• Ability to define problems, collect data, establish facts, and draw valid conclusions.
• Ability to interpret a variety of instructions and deal with abstract and concrete variables.
• Any combination of education, experience, and knowledge that demonstrates the ability to perform the position’s functions will be accepted.

Nice To Haves

• Continuing education in insurance, medical terminology/coding, and/or accounting.
• Knowledge of workers’ compensation, healthcare billing, ICD-9/ICD-10, CPT, RVS, U&C, fee schedules, HCPCS, and other coding schemes.

Responsibilities

• Research and resolve billing inquiries, payment questions, discrepancies, and outstanding medical bills.
• Communicate with providers, clients, and internal teams by phone and email to obtain information and resolve billing issues.
• Review medical bills, documentation, fee schedule calculations, pricing, payments, and savings for accuracy.
• Enter and process medical bills and related information accurately within bill review systems.
• Support review and resolution of outstanding incurred but not reported (IBNR) medical bills.
• Process and research appeals and reconsiderations, including reviewing claim-related documentation.
• Identify inconsistencies or missing information and coordinate appropriate follow-up.
• Build effective working relationships with hospitals, physicians, PPOs, specialty providers, and ancillary service providers.
• Serve as a billing and payment resource for internal clinical teams.
• Assist with process documentation, reporting, troubleshooting, and continuous improvement initiatives.
• Maintain knowledge of applicable regulatory, contractual, and industry requirements.

Benefits

• PPO, HDHP, and HMO health insurance options through Cigna; Kaiser options are available to California employees only.
• Competitive salaries.
• 401(k) matching contributions.
• Employer-paid life and disability insurance.
• Flexible spending and commuter accounts.
• Employer-matched HSA contributions.
• Paid time off and personal holiday programs.
• One paid volunteer day per calendar year for full-time and part-time employees.
• Learning and development opportunities, including the Learning Excellence at Paradigm (LEAP) program.

What This Job Offers

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