Bill Review Specialist - Workers Compensation - REMOTE

EK Health Services; United States; Remote; USD 25,000 - 30,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

401K

Paid Time Off

Paid Holidays

Monthly internet stipend

Equipment provided

Job summary

EK Health Services is seeking a remote Bill Review Specialist for a full-time role. You will analyze complex medical bills, apply CPT codes, review DRG guidelines, and issue payment recommendations based on contracts, state laws, and clinician notes.

You will also communicate with providers and clients to resolve issues, participate in QA, and help maintain data integrity. Ideal candidates have 2+ years in workers’ compensation bill review, strong analytical and communication skills, and

Qualifications

• High School Diploma required; some college or 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 and state laws.
• Excellent written and oral communication & interpersonal skills.

Responsibilities

• Analyze complex medical bills and make payment recommendations based on claim history, medical notes, UCR, regulations, contracts, coding guidelines, and policies.
• Review and verify proper use of billing codes and report improper use to BR Manager.
• Participate in quality assurance from receipt to final payment.
• Protect system integrity by correcting duplications and outdated data.
• Communicate with medical providers and clients to resolve bill-specific issues.
• Participate in ongoing training to enhance skills.

Skills

Medical billing

Customer service

Communication skills

Analytical thinking

Attention to detail

Education

High School Diploma

Some college or college degree preferred

Tools

MS Word

MS Excel

Email

Job description

Full-time

Description

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

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.

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

The job responsibilities will include, but are not limited to:

• 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 Holidays
• Monthly 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.