Remote (Located In Tampa) Billing Specialist

TEKsystems•Tampa, FL

6d•$25 - $28•Remote

About The Position

This person will be on the bill review team specifically working in the backlog of appeals. The Bill Review Analyst position holds accountability for accurate and timely review, processing and payment of bills to include pre-coding accuracy and adjudication of appeals/provider reconsideration requests. He would prefer them to have worked in Mitchell Smart Advisor platform which is the largest workers comp program but open to similar programs as well.

Requirements

Medical bill review/claims experience (worker’s comp billing a plus)

Responsibilities

Examines and adjudicates requests for appeals, reconsiderations, re-evaluations, and corrected bills.
Maintains knowledge of industry standard medical coding initiatives and state specific fee schedules and coding guidelines
Meets or exceeds department contractual and/or industry standards for accuracy and turnaround time
Maintains an understanding of all variations of Workers’ Compensation state rules and regulations
Maintains comprehensive knowledge of all available re-pricing opportunities (e.g. PPOs, direct contracts, etc.), ensures application as part of the adjudication process
Monitors itemized billings for excessive charges, duplications, and appropriate medical bills coding
Reviews/processes appeals and initiates refund requests, assists in the recoupment process.
Assists in the preparation of bills research reports