Billing Operations Analyst 1

Enlyte•UNAVAILABLE, UNAVAILABLE

5h•Remote

About The Position

This position requires an individual experienced in Medical Bill Review who, under minimal supervision, can independently analyze all incoming medical bills for usual and customary or fee schedule application, including re-evaluations, multi-state and multi-line of business medical bills, while meeting contracted client requirements. This individual needs to have strong written and communication skills to be able to handle provider disputes. Properly operates computers (hardware and software), while maintaining an acceptable speed and level of accuracy determined by company standards and Department manager.

Requirements

MUST BE IN THE EASTERN OR CENTRAL TIME ZONE
8:00 AM to 4:30 PM Central Time or 9:00 AM to 5:30 PM Eastern Time.
Ability to consistently meet the production and quality expectations.
Complete knowledge of CPT/ICD-9/HCPCS/NDS codes.
U&C bill review experience (6-9 months).
Fee scheduling bill review experience (9-12) months.
Multi-jurisdictional bill review experience (6+ fee schedule states).
H.S. Diploma or equivalent.
10-key by touch.
Strong written and communication skills.
Knowledge of: CPT/ICD-9/HCPCS/NDC codes.
Knowledge of usual and customary bill review application.
Knowledge of fee scheduling bill review application.
Multi-jurisdictional bill review experience (3+ fee schedule states).

Responsibilities

Enter and independently review professional services from client submitted medical bills in bill review system covering: Medical bills in Smartadvisor
Analysis on all U & C exposures
Analysis for 6+ assigned states having fee schedules
Multi-state Jurisdiction
Multi-Line Business
Hospital billing
Provider file maintenance
Claim file maintenance
Handle Re-evaluation disputes
Independent research on usual and customary/fee schedule application and system interface.
Interface in training co-workers.
Provide Quality Review as assigned by Lead/Supervisor.
Provide feedback type training in quality assurance of work product from co-workers.
All other duties as assigned by the Lead/Supervisor.