Remote Bill Review Specialist – Workers' Comp

Ethos; Irving (TX); Remote; USD 60,000 - 90,000; Full time

Benefits offered by this job

Paid Time Off

Medical, Dental, and Vision Insurance

Life Insurance

Short-Term & Long-Term Disability

401(k) Matching

Employee Referral Bonus Program

Job summary

Ethos Risk Services is seeking a full-time Bill Review Specialist (REMOTE) to review, audit, and process workers' compensation medical bills for reimbursement accuracy and regulatory compliance.

The role requires 3–5 years in bill review, strong CPT/ICD-10/HCPCS knowledge, and experience with Conduent Strataware and CompIQ. You will analyze bills, research provider appeals, and draft determinations while collaborating with cross-functional teams.

Qualifications

• 3–5 years of workers' compensation bill review experience.
• Knowledge of CPT, ICD-10, HCPCS.
• Experience using Conduent Strataware and CompIQ.
• Experience applying multi-state fee schedules and client guidelines.
• Experience researching reimbursement issues and regulatory guidance.
• Experience managing provider appeals and billing disputes.

Responsibilities

• Analyze Medical Bills – review and adjudicate hospital, ASC, DME, pharmacy, transportation, home health, and other bills.
• Research provider appeals and billing disputes using fee schedules and regulations.
• Prepare reimbursement determinations with clear, professional explanations.
• Communicate with providers regarding reimbursement decisions and queries.
• Support cross-functional teams to resolve billing issues and meet objectives.

Skills

CPT knowledge

ICD-10 knowledge

HCPCS knowledge

Billing accuracy

Regulatory compliance

Multi-state fee schedules

Provider communication

Education

High school diploma or equivalent

Associate's degree or higher preferred

Tools

Conduent Strataware

CompIQ

Job description

Ethos Risk Services is seeking a full-time Bill Review Specialist (REMOTE) to review, audit, and process workers' compensation medical bills for reimbursement accuracy and regulatory compliance.

The role requires 3–5 years in bill review, strong CPT/ICD-10/HCPCS knowledge, and experience with Conduent Strataware and CompIQ. You will analyze bills, research provider appeals, and draft determinations while collaborating with cross-functional teams.