CAS Bill Review Auditor

Heartland Security Insurance Group; Tyler (TX); On-site; USD 42,000 - 56,000; Full time

Job summary

Heartland Security Insurance Group is seeking a Bill Review Auditor for Claims Administrative Services, Inc. to adjudicate workers’ compensation medical bills. This position performs administrative and clerical work in processing and controlling medical expenses related to Workers’ Compensation.

Responsibilities include entering pre-coded billing data, checking eligibility, handling written and verbal communications, applying company rules, and meeting production goals with 98% accuracy.

Qualifications

• Knowledge of ICD-9/ICD-10 coding and medical terminology.
• Strong typing speed and data-entry accuracy.
• Excellent written and verbal communication skills.
• Detail-oriented with ability to work in a team.
• Familiarity with MS Word, Excel and Outlook.

Responsibilities

• Adjudicate workers' compensation medical bills with accuracy.
• Enter pre-coded billing data and verify output.
• Check eligibility for payment and interpret rules.
• Maintain timely communication with providers and teammates.
• Meet production goals and maintain high accuracy.

Skills

ICD coding

Typing 50 wpm

Attention to detail

Communication

Teamwork

Education

High school diploma

College degree preferred

Tools

MS Word

Excel

Outlook

10-key by touch

Job description

Claims Administrative Services, Inc (CAS) has served as a third-party administrator handling workers' compensation and property and casualty claims for a wide array of clients since 1990. In addition to our claims experience, CAS offers safety and loss control, cost containment services, and program administration. Every day our experienced professionals are on the job, reducing the frequency and severity of workplace injuries, managing associated claims costs, and helping injured employees return to work. Our personalized customer service combined with dedicated experience, innovation, and cost efficiency, assists our clients in reducing costs and protecting their employees.

Structure and Ownership

Heartland Security Insurance Group is the holding company for Claims Administrative Services, Inc. Heartland is comprised of seven different insurance and risk management businesses, providing products and services globally. Each of the companies offer solutions to distinct client groups in the federal, state and private sectors. The organization has been under continuous private family ownership for 50 years. Today, it has over 60 stockholders as well as ESOP ownership. In addition to providing an important retirement benefit to associates, the Employee Stock Ownership Plan (ESOP) assures that everyone in the organization has a vested interest in providing the very highest level of service to the client.

Commitment to the Community

Claims Administrative Services, Inc., and the parent organization, Heartland Security Insurance Group, have a long history of philanthropy to the local, national, and international communities.

Primary Responsibility

The Bill Review Auditor is responsible for the adjudication of workers’ compensation medical bills. This position performs administrative and complex clerical work in processing and controlling medical expenses related to Workers’ Compensation.

Essential Functions & Responsibilities

• Enter pre-coded billing data into system and verify output as it relates to Workers Compensation medical bills.
• Check eligibility for payment.
• Answer verbal and written communication.
• Interpret and apply company rules and procedures.
• Other light clerical and administrative duties.
• Meet or exceed production goal (set based on experience).
• Maintain an accuracy ratio of at least 98%.

Required Qualifications

• 1-2 years of relevant medical billing or coding administrative experience.
• High school diploma or equivalent.

Preferred Qualifications

• A college degree or some college preferred.

Knowledge, Skills & Abilities

• Must display a working knowledge and understanding of ICD-9, ICD-10, HCPCS, CPT coding, and medical terminology.
• Must be proficient in MS Word, Excel, and Outlook.
• Must be proficient in 10 key by touch.
• Must be able to type minimum 50 wpm.
• Must be proficient in Microsoft Outlook, Word and Excel.
• Must possess good oral and written communication skills.
• Must have strong attention to detail.
• Ability to work with a team.
• Ability to work independently.
• Ability to make prompt decisions.
• Ability to meet or exceed timed deadlines.
• Ability to perform fast data entry with a high degree of accuracy.