Medical Bill Reviewer I

Sentry Insurance Agency • Stevens Point, WI

6d • Hybrid

About The Position

Join our Medical Bill Reviewing team and ensure accurate processing of wage loss/medical claims data by applying laws and regulations; handle routine bills and escalate complex issues. As a Medical Bill Reviewer I, you’ll perform a review of medical bills submitted into our Personal Injury Protection department to ensure correct billing and payment practices. Additionally, you’ll: Review, evaluate, and process Personal Injury Protection (PIP) medical bills. Utilize knowledge of medical coding requirements; including CPT/HCPCS/Revenue codes, ICD-9/ICD-10 coding, and CMS-1500/UB-04 forms to process and pay PIP medical bills. Follow established state and federal medical bill review rules and regulations. Communicate with medical providers regarding payment or denial of payment. Perform well in a production-based environment regarding timely and accurate processing of PIP medical bills. Provide superior customer service while connecting with medical providers, vendors, and internal customer inquiries relating to medical bill processing.

Requirements

• Technical diploma or equivalent work experience
• 1-3 years of related work experience in a medical office, insurance environment, or medical coding beneficial
• Basic knowledge of ICD9/ICD10, CPT, HCPCS codes necessary for accurate processing
• PC knowledge including Excel as well as keyboarding, math aptitude, and organizational skills
• Proficient analytical and decision-making skills with the ability to work independently
• High level of communication, customer service, and telephone skills required
• Ability to work within deadlines, maintain confidentiality, and work with detail and a high level of accuracy is essential

Nice To Haves

• Associate Degree in Health Informatics/Health Information/Medical Coding preferred

Responsibilities

• Review, evaluate, and process Personal Injury Protection (PIP) medical bills
• Utilize knowledge of medical coding requirements; including CPT/HCPCS/Revenue codes, ICD-9/ICD-10 coding, and CMS-1500/UB-04 forms to process and pay PIP medical bills
• Follow established state and federal medical bill review rules and regulations
• Communicate with medical providers regarding payment or denial of payment
• Perform well in a production-based environment regarding timely and accurate processing of PIP medical bills
• Provide superior customer service while connecting with medical providers, vendors, and internal customer inquiries relating to medical bill processing

Benefits

• Hybrid work model
• In-office workspace and materials for home office
• Laptop provided prior to start
• Equipment for home office provided
• Meal Subsidy available for associates who report to an office
• 401(K) plan with a dollar for dollar match on your first eight percent, plus immediate vesting
• Sentry University (SentryU)
• Tuition Reimbursement program
• Generous Paid-Time Off plan
• Volunteer-Time off
• Group Medical, Dental, Vision, Life insurance
• Parental leave
• Health and Wellness benefits
• Well-being and Employee Assistance programs
• Sentry Foundation gift matching program

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: Associate degree