Bill Review Team Lead - Workers Compensation - REMOTE!

EK Health Services Inc.•Phoenix, AZ

11d•$44,000 - $46,000•Remote

About The Position

The Bill Review Team Lead assists the medical bill review department staff daily and 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 oversees daily work allocation and inventory, supports staff with questions, provides performance feedback, and analyzes complex medical bills to make payment recommendations. Recommendations are based on claim history, medical notes, usual and customary rates, applicable regulations and fee schedules, available provider network contracts, coding guidelines, client instructions, and company policies. The role also supports client workflows and issue resolution, quality assurance, provider communications, and ongoing staff training. The position pays $44,000–$46,000 depending on experience, education, and location. The company provides medical, dental, and vision insurance, a 401(k), paid time off, paid holidays, a monthly internet stipend, and equipment. The employee must maintain a safe, HIPAA-compliant home office and have DSL, fiber, or cable internet; 100 Mbps or better is preferred.

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, including 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 lbs.
Ability to sit and keyboard for the majority of an 8-hour day, apart from lunch and breaks; manual dexterity; and ability to speak on the telephone intermittently throughout the day.
Fluent English reading and writing ability.
Ability to provide and confirm a safe home office environment that is HIPAA compliant.
DSL, fiber, or cable internet connection from home.

Nice To Haves

CPC (Certified Professional Coding) coursework or certification.
Internet connection of 100 Mbps or better is preferred.

Responsibilities

Manage daily inventory.
Monitor, manage, and assign work and tasks to all bill review staff, regardless of role.
Provide consistent performance feedback to all bill review staff; the posting specifies no less than monthly/yearly feedback.
Assist bill review staff with questions.
Analyze complex medical bills and make payment recommendations based on 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.
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 prompt 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.