Bill Review Specialist - Workers Compensation - REMOTE

EK Health Services•Tampa, FL

1d•Remote

About The Position

Reporting to the Bill Review Supervisor, the Bill Review Specialist accurately analyzes and processes large, complex medical bills. 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.–4 p.m. local time. Applicants residing in California, New York, or Hawaii are not being considered.

Requirements

High school diploma.
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 such as 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 the majority of an 8-hour day, except during lunch and breaks; manual dexterity; and ability to speak on the telephone intermittently throughout the day.
Fluency in reading and writing English.
Ability to provide and confirm a safe home-office environment that is HIPAA compliant.
DSL, fiber, or cable home internet connection; 100 Mbps or better 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 payment recommendations based on claim history, medical notes, usual and customary rates, statutory regulations including state laws and fee schedules, available MPN/PPO contracts, coding guidelines, client instructions, and company policies and procedures.
Review and verify correct use of medical billing codes and report improper coding to the Bill Review Manager.
Participate in quality assurance from initial bill receipt through final payment.
Protect system integrity by monitoring and correcting duplicate entries and inaccurate or outdated data.
Communicate with medical providers to obtain needed information and resolve bill-specific issues.
Communicate directly with clients and respond to their questions quickly and professionally.
Participate in ongoing training to enhance job skills and knowledge.
Perform other duties as assigned.