Bill Review Specialist III - Growth & Benefits

InterMed Cost Containment Services; Rocklin (CA); Sur place; USD 36 000 - 39 000; Plein temps

Avantages offerts par ce poste

Comprehensive medical benefits

Dental benefits

Vision benefits

401(k) with company match

PTO and holidays

Résumé du poste

AvonRisk is seeking a detail-oriented Medical Billing Clerk to process and audit medical bills under limited supervision, ensuring compliance with workers’ compensation fee schedules and company standards. The role emphasizes accuracy, speed, and collaboration with BR supervisors and clients.

Responsibilities include coding, screening for medical necessity, determining reimbursements using CPT/ ICD codes, and communicating with providers to resolve issues.

Qualifications

• High school diploma or GED, plus minimum of one year data entry/medical billing experience; additional two years bill review experience in a workers’ comp environment.
• Strong knowledge of CPT and ICD9/ICD10 coding and workers’ compensation fee schedules.
• Must be familiar with workers’ compensation regulations and have good comprehension of company software system process.

Responsabilités

• Codes medical bills into the company system with speed and accuracy, maintaining production standards.
• Performs preliminary screening for appropriateness and medical necessity of services rendered.
• Uses CPT and ICD9/ICD10 codes, fee schedules, and other materials to determine appropriate reimbursement.
• Flags any problem bills to the BR supervisor.
• Communicates with clients and/or providers to clarify information.
• May assist in answering provider calls.

Connaissances

Data entry

Medical billing

CPT ICD coding

Attention to detail

Formation

High School Diploma or GED

Outils

Word Processing

Spreadsheets

Database

Description du poste

AvonRisk is seeking a detail-oriented Medical Billing Clerk to process and audit medical bills under limited supervision, ensuring compliance with workers’ compensation fee schedules and company standards. The role emphasizes accuracy, speed, and collaboration with BR supervisors and clients.

Responsibilities include coding, screening for medical necessity, determining reimbursements using CPT/ ICD codes, and communicating with providers to resolve issues.