[Hiring] Bill Review Specialist @EK Health Services Inc.

Role Description

Reporting to the Bill Review Supervisor, a Bill Review Specialist is responsible for accurately analyzing and processing large, complex medical bills. Bill Review requires an affinity for medical billing, coding and claims, and a meticulous attention to detail to identify errors and discrepancies.

• Full-time, Non-Exempt position; working remotely, Monday through Friday, 7am-4pm local time
• Accurately and appropriately analyze complex medical bills and make payment recommendations based on:
  • Claim history
  • Medical notes
  • Usual and customary rates (UCR)
  • Statutory regulations including state laws and fee schedules
  • Available MPN/PPO contracts
  • Coding guidelines
  • Client instructions
  • Company policies and procedures
• Reviews and verifies the correct use of medical billing codes and reports the detection of improper use of billing codes to BR Manager.
• Participate in the quality assurance (QA) process from initial receipt of bills through final payment.
• Protect system integrity: monitoring and correcting duplications and inaccurate/outdated data.
• Communicate with medical providers to obtain needed information and resolve bill-specific issues.
• Communicate directly with clients, offering excellent customer service by responding to and answering their questions quickly and professionally.
• Participate in ongoing training to enhance job skills and knowledge.
• Other duties as assigned.

Qualifications

• High School Diploma required, some college or college degree preferred
• 2+ years of experience in complex Workers' Compensation Bill Review with customer service exposure.
• Knowledge of medical terminology, CPT codes, and DRG.
• Ability to read, analyze, and interpret technical procedures, medical reports, state laws and fee schedules.
• Hospital Bill Review experience a plus.
• CPC (Certified Professional Coding) coursework or certification a big plus.
• Excellent Written and Oral Communication & Interpersonal Skills
• Strong Organization Skills
• High comfort level with computers and computer programs (MS Word, MS Excel, Email)
• Ability to meet deadlines in a high pressure, time sensitive environment
• Ability to lift to 20 lbs.

Requirements

• Candidate must be able to sit the majority of an 8-hour day except for lunch and break times.
• Candidate must be able to keyboard the majority of an 8-hour day except for lunch and break times.
• Candidate must have manual dexterity.
• Candidate must be able to speak on the telephone intermittently throughout the day.
• Candidate must be able to read and write English fluently.
• Candidate must be able to provide and confirm safe home office environment. Home office must be HIPAA compliant.
• Requires DSL, fiber, or cable internet connection from home 100 Mbps preferred or better.

Benefits

• Pay $18-22/hr based on experience, education and location
• Medical, Dental and Vision Insurance
• 401K
• Paid Time Off
• Paid Holidays
• Monthly internet stipend
• Equipment provided