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Bill Reviewer III

InterMed Cost Containment Services

AvonRisk is the nation’s leading specialty risk manager for self-insured organizations, uniting respected regional leaders in workers’ compensation, liability, managed care, and risk management across 32 states. With nearly 700 professionals and brands including Intercare, InterMed, George Hills, and AS&G Claims Administration, the company emphasizes reasonable caseloads, strong training, collaborative teams, and expert support.

Under limited supervision, this role meets daily production quotas in processing and auditing medical bills in accordance with the appropriate workers’ compensation fee schedule. The position codes medical bills into the company system with speed and accuracy, performs preliminary screening for appropriateness and medical necessity, uses CPT and ICD9/ICD10 codes and fee schedules to determine reimbursement, flags problem bills, communicates with clients and providers, and processes reconsideration requests as assigned. The role may also specialize in state-specific or client-specific responsibilities and assist with provider calls.

Requirements & Qualifications

High school diploma or GED.

Minimum of 1 year of data entry or medical billing experience, plus an additional 2 years of bill review experience in a workers’ compensation environment.

Strong knowledge of CPT and ICD9/ICD10 coding and workers’ compensation fee schedules.

Familiarity with workers’ compensation regulations and company software systems.

Excellent oral and written communication skills.

Ability to read and interpret documents, write routine reports and correspondence, and communicate effectively.

Ability to add, subtract, multiply, and divide; compute rate, ratio, and percent; and interpret basic graphs.

Ability to apply common sense understanding to written, oral, and diagram instructions.

Computer skills including word processing, spreadsheet, and database software.

Must have Medical Bill Reviewer Designation with 40-hour initial certification and continuing education of 16 hours every 2 years.

Benefits & Perks

Comprehensive medical, dental, and vision benefits

Company contributions to HSA and FSA plans

Employer-paid life and disability insurance

401(k) with company match

Paid time off and company-paid holidays

Learning and development opportunities for career advancement

Employee assistance resources and a supportive culture focused on balance and wellbeing

Location

California, US

Employment Type

Full-time

Experience Level

Intermediate Level

Remote work allowed

No

Posted

4 months ago

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