[Hiring] Senior Bill Review Analyst @Valenz
Mar 28, 2025 - Valenz is hiring a remote Senior Bill Review Analyst. 💸 Salary: unspecified. 📍Location: USA.
Role Description
As a Bill Review Analyst, you will pre-screen claims to identify unbundled charges and billing errors, resolving escalated cases that require coding expertise. You will perform in-depth reviews based on accepted billing practices and coding rules. With this information, you will provide timely insights to our internal teams and management to achieve savings for clients.
To be successful in this role, you will be a strong communicator, possess excellent problem-solving skills, and a knack for detail and organization.
Things You’ll Do Here:
- Identify overcharges, unbundled codes and other discrepancies.
- Ensure codes are accurate and relevant and verify the correct use of modifiers.
- Stay updated on medical coding guidelines and regulations.
- Ensure adherence to national and industry billing standards by verifying the proper use of codes and accurately applying bundling and unbundling rules.
- Work collaboratively with the Negotiation team to resolve claim issues and obtain additional discounts.
- Communicate all findings to clients by providing a Bill Review Report that can be reviewed with clients at their request.
- Evaluate and respond to bill reconsideration requests.
- Communicate with providers to query or to resolve billing discrepancies and respond to appeals.
- Educate staff and clients on any updated information on codes/edits.
- Formulate and document department processes and policies.
- Track and trend bill review.
- Partner with team and direct supervisor in achieving departmental goals and suggestions that will increase revenue relating to Bill Review.
- Comply with/support HIPAA standards.
- Identify system/process issues and communicate potential resolutions.
Qualifications
- 3+ years of auditing, claims, review and/or billing experience with a healthcare organization
- Encoder Pro and/or Find-A-Code software experience
- Experience in bill review and line charge verifications
- Working knowledge of industry coding, ICD-10, CPT, HCPCS Revenue codes etc.
- Excellent communication skills, both verbal and written.
- Knowledge of CMS guidelines
Requirements
- A plus if you have experience in DRG validation
- CPC and/or CIC certifications
- Knowledge of Health Insurance, Medicare guidelines and various healthcare programs
- Experience with TPAs, MGUs, Brokers and Stop Loss clients
Benefits
- Generously subsidized company-sponsored Medical, Dental, and Vision insurance, with access to services through our own products, Healthcare Blue Book and KISx Card.
- Spending account options: HSA, FSA, and DCFSA
- 401K with company match and immediate vesting
- Flexible working environment
- Generous Paid Time Off to include vacation, sick leave, and paid holidays
- Employee Assistance Program that includes professional counseling, referrals, and additional services
- Paid maternity and paternity leave
- Pet insurance
- Employee discounts on phone plans, car rentals and computers
- Community giveback opportunities, including paid time off for philanthropic endeavors
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| 📍 | Be aware of the location restriction for this remote position: USA |
| ‼ | Beware of scams! When applying for jobs, you should NEVER have to pay anything. Learn more. |
|
Salary
💸
unspecified
|
Remote
Location
USA
|
|
Job Type
full-time
|
Posted
Mar 28, 2025
|
| 📍 | Be aware of the location restriction for this remote position: USA |
| ‼ | Beware of scams! When applying for jobs, you should NEVER have to pay anything. Learn more. |
