Bill Review Specialist - Workers Compensation - REMOTE

EK Health Services Inc.•Phoenix, AZ

1d•$18 - $22•Remote

About The Position

The Bill Review Specialist accurately analyzes and processes large, complex medical bills and makes payment recommendations. The role requires an affinity for medical billing, coding, and claims, along with meticulous attention to detail to identify errors and discrepancies. The position reports to the Bill Review Supervisor. This is a full-time, non-exempt remote position, Monday through Friday, 7 a.m.–4 p.m. local time. Applicants residing in California, New York, or Hawaii are not being considered. The role requires a safe, HIPAA-compliant home office and a DSL, fiber, or cable internet connection; 100 Mbps or better is preferred.

Requirements

High school diploma required.
At least 2 years of experience in complex Workers' Compensation bill review, with customer service exposure.
Knowledge of medical terminology, CPT codes, and DRG.
Ability to read, analyze, and interpret technical procedures, medical reports, state laws, and fee schedules.
Excellent written and oral communication and interpersonal skills.
Strong organizational skills.
Comfort using computers and programs including MS Word, MS Excel, and email.
Ability to meet deadlines in a high-pressure, time-sensitive environment.
Ability to lift up to 20 pounds.
Ability to sit and keyboard for most of an 8-hour day, except for lunch and breaks; manual dexterity; and ability to speak on the telephone intermittently throughout the day.
Fluent English reading and writing skills.
Ability to provide and confirm a safe, HIPAA-compliant home office.
DSL, fiber, or cable home internet connection required.

Nice To Haves

Some college or a college degree.
Hospital Bill Review experience.
CPC (Certified Professional Coding) coursework or certification.
Home internet speed of 100 Mbps or better is preferred.

Responsibilities

Analyze complex medical bills and make payment recommendations based on claim history, medical notes, usual and customary rates, statutory regulations and state fee schedules, available MPN/PPO contracts, coding guidelines, client instructions, and company policies and procedures.
Review and verify the correct use of medical billing codes and report improper coding to the BR Manager.
Participate in quality assurance throughout the bill process, from initial receipt through final payment.
Protect system integrity by monitoring and correcting duplicate records and inaccurate or outdated data.
Communicate with medical providers to obtain needed information and resolve bill-specific issues.
Respond promptly and professionally to client questions and provide customer service.
Participate in ongoing training to enhance job skills and knowledge.
Perform other duties as assigned.