Bill Review Specialist

Paradigm

12d • Remote

About The Position

Paradigm is seeking a full-time, remote Bill Review Specialist. The Bill Review Specialist is responsible for or assists in a wide array of bill review related functions, holds accountability within an assigned area for obtaining, reviewing, processing and auditing outstanding medical billing for accuracy and proper payment, as well as intake, tracking, resolution, and communication of billing inquiries/issues. Receive phone and email inquiries from internal stakeholders, providers and/or clients with questions regarding claims. Have an outstanding attention to detail, question things that do not appear correct and possess a desire to succeed and progress quickly.

Requirements

• High School Diploma; successful completion of continuing education in insurance, medical terminology/coding, and/or accounting preferred
• 5 years customer service experience with a minimum of 2 years worker s comp, healthcare, claims and/or bill review experience.
• Proficiency in Microsoft Word, Excel, and Outlook.
• Strong organizational and analytical skills.
• Knowledge of workers comp billing, ICD-9/ICD-10, CPT, HCPCS, RVS, U&C, and fee schedules preferred.
• Excellent oral communication and phone presence.
• Ability to interpret instructions, resolve problems, and manage abstract and concrete variables.

Responsibilities

• Respond to billing inquiries and payment questions from internal teams, providers, and clients via phone, email, and mail.
• Research and resolve issues related to billing discrepancies, pricing accuracy, and outstanding incurred but not reported (IBNR) bills.
• Perform data entry of bills into the bill review system and assist with appeals and reconsiderations.
• Analyze claim documentation, fee schedules, and savings calculations for accuracy.
• Communicate effectively with providers to educate on billing processes and facilitate payment resolution.
• Participate in interdepartmental meetings and support integrated projects.
• Maintain up-to-date knowledge of regulatory, industry, and contractual requirements.
• Ensure compliance with Paradigm s information security policies.

What This Job Offers

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