Medical Bill Coordinator - Remote

Sedgwick

7d•$18 - $23•Remote

About The Position

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve. Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance

Requirements

High School diploma or GED required.
Two (2) years workers' compensation and/or bill review experience or equivalent combination of education and experience required to include provider appeals experience.
Knowledge of re-pricing rules and guidelines
Knowledge of medical terminology, anatomy and surgical terms
Knowledge of multiple state jurisdictional regulations and rules
Knowledge of Fee Schedules, Rules, and U&C Guidelines
Knowledge of CPT/ICD9
PC literate, including Microsoft Office products
Leadership skills and ability to motivate others
Strong verbal and written communication skills
Strong interpersonal skills
High level of accuracy and attention to detail
Ability to multi-task and function in high volume area
Ability to handle deadlines and proactively problem solve
Ability to work in a team environment
Ability to meet or exceed Performance Competencies

Nice To Haves

PPO re-pricing, surgery review, by report and RNE review preferred.
Two (2) years of experience with complex medical, legal, and consult review preferred.

Responsibilities

Processes bills in accordance with multi state schedules, rules, regulations, and guidelines.
Applies PPO contract discounts to bills.
Reviews operative reports to determine if surgery services were appropriately billed.
Reviews complex medical, legal and consult services.
Contacts client or facility to obtain additional or missing information.
Handles provider appeals where appropriate to fee schedule and contractual disputes.
Communicates internal issues to management.
Assists bill review team lead with workflow management, coaching and mentoring of staff.
Assists with process, procedure and system training for new staff.
Performs other duties as assigned.
Supports the organization's quality program(s).
Travel as required.