Bill Review Specialist - Workers Compensation - REMOTE

EK Health Services Inc.•Tampa, FL

1d•$18 - $22•Remote

About The Position

The Bill Review Specialist accurately analyzes and processes large, complex medical bills and makes payment recommendations using claim history, medical notes, usual and customary rates, statutory regulations, state laws and fee schedules, available MPN/PPO contracts, coding guidelines, client instructions, and company policies and procedures. The role requires an affinity for medical billing, coding, and claims, along with meticulous attention to detail to identify errors and discrepancies. This is a full-time, non-exempt remote position, Monday through Friday, 7 a.m. to 4 p.m. local time. Applicants residing in California, New York, or Hawaii are not being considered. The role reports to the Bill Review Supervisor.

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.
High comfort level with 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.
Able to sit and keyboard for most of an 8-hour day, except during lunch and breaks; manual dexterity is required.
Able to speak on the telephone intermittently throughout the day and read and write English fluently.
Must be able to provide and confirm a safe, HIPAA-compliant home office environment.
Requires DSL, fiber, or cable internet from home; 100 Mbps or better is preferred.

Nice To Haves

Some college or a college degree.
Hospital Bill Review experience.
CPC (Certified Professional Coding) coursework or certification.

Responsibilities

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Protect system integrity by monitoring and correcting duplications and inaccurate or outdated data.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