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.
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.
Education/Experience: High school diploma or GED,