Bill Review Team Lead - Workers Compensation - REMOTE!

EK Health Services Inc.; Oregon; Hybride; USD 44 000 - 46 000; Plein temps

Avantages offerts par ce poste

Medical, Dental and Vision Insurance

401K

Paid Time Off

Paid Holidays

Monthly internet stipend

Equipment provided

Résumé du poste

EK Health Services Inc. is seeking a Bill Review Team Lead to guide the daily operations of the medical bill review staff. You will develop, train, and coach reviewers, ensure accurate analysis, and make payment recommendations based on claim history, UCR, and applicable regulations.

This full-time, exempt role is remote Monday through Friday, 7am-4pm in any time zone, with PST timing during training. The position supports client workflows and requires strong leadership and communication skills

Qualifications

• High School Diploma required.
• 3+ years of experience in complex Workers' Compensation Bill Review with customer service exposure.
• Knowledge of medical terminology, CPT codes, and DRG.
• CPC coursework or certification a big plus.
• Experience supervising staff in a fast-paced environment.

Responsabilités

• Manage daily inventory.
• Monitor, manage, and assign work/tasks to all bill review staff.
• Provide consistent monthly/yearly performance feedback to all bill review staff.
• Assist Bill review staff with questions.
• Analyze complex medical bills and make payment recommendations based on claim history, medical notes, and regulations.
• Maintain knowledge of client workflows/protocols (indexing, processing rules).
• Work with management on resolution of client rejection files.
• Handle client inquiry email box.
• Participate in the QA process from receipt to final payment.
• Communicate with medical providers to obtain information and resolve issues.
• Respond to issues and drive quick problem resolution.

Connaissances

Medical terminology

CPT codes

DRG

Customer service

Staff supervision

Problem analysis

Communication

Formation

High School Diploma

CPC coursework or certification

Outils

MS Word

MS Excel

Email systems

Description du poste

DescriptionPlease note: At this time, we are not accepting or considering applicants residing in California (CA), New York (NY), orHawaii (HI).Under the direction of BR Supervisor, the Bill Review Team Lead is responsible for assisting the medical bill review department staff daily. Team Lead is also responsible for building a high-performance culture by developing, training, and coaching the BR reviewers. 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, Exempt position; remote Monday through Friday, 7am-4pm any time zone (PST time during training)

Job Responsibilities

• Manage daily inventory
• Monitoring, managing, and assigning work/tasks to all bill review staff (regardless of role)
• Providing consistent, but no less than monthly/yearly performance feedback to all bill review staff
• Assisting Bill review staff with questions
• 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
• Maintain knowledge of all client workflows/protocols (indexing, processing rules, etc.)
• Work with management team on resolution of client rejection files
• Handle client inquiry email box
• Participate in the quality assurance (QA) process from initial receipt of bills through final payment
• Communicate with medical providers to obtain needed information and resolve bill‑specific issues
• Respond to issues and drive problem resolution in a quick turn- around time
• Participate in ongoing training to enhance job skills and knowledge
• Continuous working knowledge of Ahshay and Billtelligent
• Demonstrate positive behavior and lead by example to improve work environment
• Support and assist all levels of the organization
• Other duties as assigned

Pay & Perks

• Pay $44K - $46K 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
• 3+ 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.
• CPC (Certified Professional Coding) coursework or certification a big plus.
• Experience supervising staff members.
• Demonstrate the ability to manage people in a fast pace environment
• Good Written and Oral Communication Skills
• Good Interpersonal Skills
• Good Organization Skills
• Good comfort level with computers and computer programs (MS Word, MS Excel, Email)
• Ability to work independently with minimal supervision
• Ability to meet deadlines in a high pressure, time sensitive environment
• Ability to lift up 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. *