Temp Bill Reviewer III

Essential duties

• Code medical bills into the company system with speed and accuracy while maintaining production standards.
• Perform preliminary screening for appropriateness and medical necessity of services rendered.
• Use CPT and ICD-9/ICD-10 codes, fee schedules, and other reference materials to determine appropriate reimbursement and repricing rationale.
• Flag problem bills to the Bill Review supervisor.
• Communicate with clients and providers to clarify information.
• Forward unidentifiable or unlisted procedure numbers to the Bill Review supervisor.
• Price hospital and surgery bills to applicable fee schedules.
• Process reconsideration requests as assigned.
• May specialize in state-specific or client-specific responsibilities.
• May assist with answering provider calls.

Qualifications

• High school diploma or GED.
• Minimum 1 year of data entry or medical billing experience.
• Additional 2 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.
• Excellent oral and written communication skills.
• Must have a Medical Bill Reviewer designation with 40-hour initial certification plus 16 continuing education hours every 2 years.

Benefits

• 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
• Supportive culture focused on balance and wellbeing