Medical Bill Reviewer

Summit Consulting•Lakeland, FL

2d•Hybrid

About The Position

Summit provides independent insurance agents and their clients with market-leading workers’ comp insurance and elite customer service. We’re growing and currently serve more than 7,000 independent agents and 31,000 policyholders across the South, Midwest, and Mid-Atlantic. Our strength comes from a single-minded focus on workers’ comp and a commitment to long-term customer relationships. Summit is who you turn to when you need a specialist who not only knows workers’ comp but also gets to know your business and your priorities. Our field team members are located in every state in which we operate. Summit is a member of the Great American Insurance Group where our highest goal is for all employees to feel included, respected, and empowered to perform at their best. This position is not eligible for employment visa sponsorship. Applicants must be authorized to work in the United States without the need for current or future sponsorship.

Requirements

High School Diploma or equivalent.
Generally, a minimum of 3 years of experience in medical billing.
Proficiency in medical terminology and billing software.
High attention to detail and accuracy.
Knowledge of insurance billing policies and third-party payers.
Strong customer service skills for handling patient inquiries related to billing.
Ability to manage multiple tasks and prioritize workload.
Proven ability to handle confidential information with discretion.

Nice To Haves

Completion of or continuing progress toward a medical billing and coding designation preferred, such as Certified Professional Coder (CPC) or Certified Coding Specialist – Physician-based (CCS-P).

Responsibilities

Reviews and processes medical bills for workers' compensation claims, ensuring accuracy and compliance with company policies and regulatory requirements.
Determines the validity of medical bills by cross-referencing with claim details and medical records.
Assists with reconciling billing discrepancies and resolving issues with medical providers and claimants.
Ensures all billing practices comply with state and federal regulations, including HIPAA and workers' compensation laws.
Provides support to claimants and medical providers.
Assists with addressing inquiries and resolving billing disputes.
Maintains accurate and up-to-date records of all billing activities and communications.
Generates reports on billing activities.
Participates in collaborating with claims representatives, medical providers, and other internal departments to ensure seamless processing of medical bills.
Assists in identifying training issues and may assist with providing training to processors.
Performs other duties as assigned.