Bill Review Analyst

Job Location(s) US-UT-Sandy
Job ID
2017-1521
# of Openings
1
Category
Bill Review
Job Type
Temporary Part-Time

Overview

POSITION SUMMARY:   Any and all steps necessary to process bills according to state fee schedule guidelines, usual and customary review, in addition to PPO contracted rates and Specialty Bill review cases. Bills may include, but not be limited to complex bills, routine or simple surgical bills, simple outpatient/ASC bills and Inpatient and Outpatient medical bills. Bill review position requires experience in Workers’ Compensation as well as First and Third Party Liability bills.  Provide support for lead as needed. May work on special projects assigned by department Leads/Supervisor or Manager. Provide support for Provider Inquires.

Responsibilities

DUTIES AND RESPONSIBILITIES:

 

This position requires a dynamic individual with experience in the review of medical bills for fee schedule and usual & customary application. They must understand Medical Fee Schedules, Medical Terminology, Coordination of Benefits, ICD, CPT, HCPC, Revenue Codes, and billing forms. The right person will be responsible to maintain an acceptable productivity and accuracy level standard. Must have strong written and communication skills. They should be able to work collaboratively as well as independently and should have the ability to work in a high production environment. 

  • Reviews medical bills for accuracy, ensures codes represent treatment for the compensable injury and compliance
  • Provide support to claim staff on client service teams.
  • Process daily bill volume
  • Understand and articulate areas that impact accuracy
  • Identify system issues causing errors and report to Lead and/or Manager.
  • Maintain turn around times through work load management and oversight.
  • Continuously work to ensure prompt attention to customers' needs ( examples include:  process bills according to required timeframes, process bills distributed by any and all leads, provider inquiries, account management or department manager as required.
  • Any and all other duties as assigned or requested by leads, provider inquiries, account management or department management .

Preferred Skills

  • Knowledge of medical terminology and coding.
  • 10 key data entry
  • Proficient using Microsoft Office products such as Word, Excel, Outlook 

Qualifications

QUALIFICATIONS REQUIRED:

 

Education/Experience:  High school diploma or GED,

 

QUALIFICATIONS REQUIRED:

 

  • 5 plus years in Workers Compensation Bill Review, first and third party liability is a plus
  • Proven medical billing technical experience
  • Self starter – ability to work independently
  • Solid understanding of medical billing rules and regulations, bill standards, state guidelines and job aids
  • Strong organizational and analytical skills
  • Working knowledge of Medical Bill Processing
  • Excellent written and verbal communication and diplomacy skills, inspiring confidence among Bill Review team
  • Strong time and desk management skills and ability to manage multiple projects
  • Demonstrated customer service skills
  • Demonstrated computer literacy
  • Proven dedication and flexibility
  • Proven ability to work independently
  • Excellent communication, planning and people skills

 

Other Qualifications

  • None

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