Provider Relations Specialist (Bill Review) - REMOTE - Any State

Talentify.io; United States; Remote; USD 60,000 - 80,000; Full time

Job summary

An innovative healthcare services company is seeking a detail-oriented individual to join their team as a Medical Bill Reviewer. In this role, you will analyze various medical bills, ensuring compliance with applicable regulations while enhancing your customer service skills. The position offers a flexible work-from-home option, comprehensive benefits including medical, dental, and vision insurance, and a supportive environment that prioritizes work-life balance. If you are passionate about the healthcare industry and have a knack for problem-solving, this opportunity could be the perfect fit for you.

Benefits

Medical Insurance

Dental Insurance

Vision Insurance

401K Plan

Paid Time Off

Paid Holidays

Qualifications

• Minimum 2 years experience in Workers' Compensation Bill Review.
• Knowledge of CPT codes and DRG is essential.

Responsibilities

• Analyze medical bills based on regulations and jurisdiction.
• Respond to provider communications within 48 hours.

Skills

Medical Terminology

Customer Service Skills

Communication Skills

Education

High School Diploma

Tools

MS Word

MS Excel

Email

Job description

Employer Industry: Healthcare Services

Why consider this job opportunity:

1. Pay: $17-20/hr based on experience and location
2. Comprehensive benefits including Medical, Dental, and Vision Insurance
3. 401K plan with employer contributions
4. Paid Time Off and Paid Holidays for work-life balance
5. Opportunity to work remotely from home
6. Chance to develop strong relationships within the provider community and enhance customer service skills

What to Expect (Job Responsibilities):

1. Analyze various types of medical bills based on claim jurisdiction and applicable regulations
2. Communicate bill processing methodologies to providers and address their inquiries
3. Respond to all provider communications within 48 hours
4. Monitor the bill review process from receipt to final payment
5. Collaborate with the Bill Review team on quality assurance issues and resolve billing discrepancies

What is Required (Qualifications):

1. High School Diploma required
2. Minimum of 2 years of experience in complex Workers' Compensation Bill Review with customer service exposure
3. Knowledge of medical terminology, CPT codes, and DRG
4. Proficiency in computer programs including MS Word, MS Excel, and Email
5. Strong written and oral communication skills

How to Stand Out (Preferred Qualifications):

1. Hospital Bill Review experience
2. Completion of CPC (Certified Professional Coding) coursework or certification
3. Familiarity with state laws and fee schedules related to medical billing

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