AvonRisk is a specialty risk manager for self-insured organizations, with a focus on workers' compensation, liability, managed care, and risk management.
Under limited supervision, this role processes and audits medical bills in accordance with the appropriate workers' compensation fee schedule while meeting daily production quotas.
The position involves reviewing billed services for appropriateness and medical necessity, applying CPT and ICD-9/ICD-10 codes, determining reimbursement using fee schedules and repricing methods, and communicating with clients and providers as needed.
Additional responsibilities may include pricing hospital and surgery bills, processing reconsideration requests, identifying problem bills, and supporting provider calls when necessary.
High school diploma or GED.
Minimum of 1 year of data entry or medical billing experience, plus 2 additional years of bill review experience in a workers' compensation environment.
Strong knowledge of CPT and ICD-9/ICD-10 coding and workers' compensation fee schedules.
Familiarity with workers' compensation regulations and company software systems.
Ability to read, interpret, and write routine reports and correspondence.
Ability to communicate effectively with customers and coworkers.
Basic math skills, including computing ratios, percentages, and interpreting graphs.
Proficiency with word processing, spreadsheet, and database software.
Medical Bill Reviewer Designation required, including 40-hour initial certification and 16 continuing education hours every 2 years.
Comprehensive medical, dental, and vision insurance
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
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
Yes
Posted
1 month ago