Bill Review Specialist - Workers Compensation - REMOTE

EK Health Services Inc.; Phoenix (AZ); Remote; USD 25,000 - 30,000; Full time

Benefits offered by this job

Medical, Dental and Vision Insurance

401K

Paid Time Off

Paid Holidays

Monthly internet stipend

Equipment provided

Job summary

EK Health Services Inc. is seeking a Bill Review Specialist to analyze and process large medical bills from a remote location.

You will evaluate claims based on medical notes, codes, and rules, and make accurate payment recommendations while ensuring regulatory compliance. The ideal candidate has 2+ years in complex workers' compensation bill review, knowledge of CPT/DRG, and excellent communication skills.

Qualifications

• 2+ years of Workers' Compensation Bill Review experience.
• Knowledge of CPT codes and DRG.
• Excellent written and oral communication.

Responsibilities

• Analyze complex medical bills and make payment recommendations based on claim history, UCR, state laws and fee schedules.
• Verify correct use of medical billing codes and report discrepancies to BR Manager.
• Participate in QA from receipt to final payment.
• Protect data integrity and correct duplications.
• Communicate with providers to obtain information and resolve issues.
• Provide excellent customer service to clients.

Skills

Attention to detail

Written and verbal communication

Time management

Computer skills

Education

High School Diploma

CPC coursework/certification

Tools

MS Word

MS Excel

Email

Job description

Description

Hawaii (HI). 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.

Please note: At this time, we are not accepting or considering applicants residing in California (CA), New York (NY), or Hawaii (HI).

Position Specifics

Full-time, Non-Exempt position; working remotely, Monday through Friday, 7am-4pm local time.

Job Responsibilities

• 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, and 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.

Pay & Perks

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

Requirements

• 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.

Physical 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. *