Remote Bill Review Team Lead - Healthcare Claims

Ek-Health-Services-Inc.-1; Phoenix (AZ); A distancia; USD 44.000 - 46.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Medical, Dental and Vision Insurance

401K

Paid Time Off

Paid Holidays

Monthly internet stipend

Equipment provided

Descripción de la vacante

Ek-Health-Services-Inc.-1 is seeking a Bill Review Team Lead to guide daily BR operations and develop a high-performance culture. You will train, coach, and supervise BR reviewers, ensuring accuracy and timely payments across complex medical bills and client rules.

The role requires strong knowledge of medical billing, coding, CPT/DRG, and state regulations, with a focus on process improvement and staff development. Remote work is offered for this full-time exempt position.

Formación

• 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 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.

Responsabilidades

• 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

Conocimientos

Communication

Interpersonal skills

Organization

Independent work

Customer service

Team supervision

Educación

High School Diploma

CPC certification

Herramientas

MS Word

MS Excel

Email

Descripción del empleo

Ek-Health-Services-Inc.-1 is seeking a Bill Review Team Lead to guide daily BR operations and develop a high-performance culture. You will train, coach, and supervise BR reviewers, ensuring accuracy and timely payments across complex medical bills and client rules.

The role requires strong knowledge of medical billing, coding, CPT/DRG, and state regulations, with a focus on process improvement and staff development. Remote work is offered for this full-time exempt position.