Bill Review Team Lead - Workers Compensation - REMOTE!

EK Health Services•Phoenix, AZ

11d•Remote

About The Position

The Bill Review Team Lead assists the medical bill review department staff daily and, under the direction of the BR Supervisor, helps build a high-performance culture by developing, training, and coaching bill review staff. The role requires an affinity for medical billing, coding, and claims, along with meticulous attention to detail when identifying errors and discrepancies. This is a full-time, exempt, remote position working Monday through Friday, 7 a.m.–4 p.m. in any time zone; training is conducted on Pacific time. Applicants residing in California, New York, or Hawaii are not being considered. The Team Lead manages daily inventory, assigns and monitors work, supports staff with questions, and provides performance feedback. The role also analyzes complex medical bills and makes payment recommendations using claim history, medical notes, usual and customary rates, laws and fee schedules, network contracts, coding guidelines, client instructions, and company procedures. Additional responsibilities include maintaining client workflow knowledge, helping resolve client rejections and inquiries, participating in quality assurance and ongoing training, communicating with providers, and supporting staff and organizational needs.

Requirements

High school diploma.
At least 3 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.
Experience supervising staff members.
Ability to manage people in a fast-paced environment.
Good written and oral communication skills.
Good interpersonal skills.
Good organizational skills.
Comfort using computers and programs such as MS Word, MS Excel, and email.
Ability to work independently with minimal supervision.
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 break times.
Manual dexterity.
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 is preferred.

Nice To Haves

CPC (Certified Professional Coding) coursework or certification.

Responsibilities

Manage daily inventory.
Monitor, manage, and assign work and tasks to bill review staff across roles.
Provide consistent performance feedback to bill review staff, no less than monthly/yearly as stated in the posting.
Assist bill review staff with questions.
Analyze complex medical bills and make appropriate payment recommendations using relevant claim history, medical notes, rates, regulations, contracts, coding guidance, client instructions, and company procedures.
Maintain knowledge of client workflows and protocols, including indexing and processing rules.
Work with the management team to resolve client rejection files.
Handle the client inquiry email box.
Participate in quality assurance from initial receipt of bills through final payment.
Communicate with medical providers to obtain needed information and resolve bill-specific issues.
Respond to issues and drive timely problem resolution.
Participate in ongoing training to enhance job skills and knowledge.
Maintain working knowledge of Ahshay and Billtelligent.
Demonstrate positive behavior and lead by example to improve the work environment.
Support and assist all levels of the organization.
Perform other duties as assigned.