Remote Provider Relations & Bill Review Specialist

EK Health Services Inc.; Oregon; Hybrid; USD 26,000 - 29,000; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

401K

Paid Time Off

Paid Holidays

Internet stipend

Equipment provided

Job summary

EK Health Services Inc. is seeking a Provider Relations Specialist to support provider relations and bill review activities.

The role involves analyzing medical bills, explaining processing methodologies to providers, and ensuring timely responses to inquiries, all while maintaining high-quality service for EK Health clients and partners. The position is full-time, non-exempt, remote with hours 8:00am–4:30pm PST, Monday–Friday.

Qualifications

• 2+ years of experience in complex Workers' Compensation Bill Review with customer service exposure.
• Knowledge of medical terminology, CPT codes, and DRG.
• Proficient with MS Word, MS Excel, and Email.
• Ability to read, analyze, and interpret technical procedures, medical reports, state laws and fee schedules.
• CPC coursework or certification is a big plus.
• Strong written and oral communication & interpersonal skills.

Responsibilities

• Analyze various medical bills based on jurisdiction, notes, UCR, statutes, contracts, coding guidelines, client instructions and company policies.
• Explain bill processing methodology to providers and re-pricing details.
• Receive provider contacts and respond within 48 hours.
• Monitor bill review from receipt to final payment.
• Verify correct use of medical billing codes and report improper coding.
• Collaborate with Bill Review team on QA issues.
• Obtain information from providers to resolve bill-specific issues.
• Provide excellent customer service to clients, adjusters and providers.
• Participate in ongoing training and development.
• Perform other duties as assigned.

Skills

Workers' Compensation

Bill Review

Customer Service

Medical terminology

CPT codes

DRG

MS Word

MS Excel

Email

Education

High School Diploma

CPC coursework or certification

Tools

MS Word

MS Excel

Email client

Job description

EK Health Services Inc. is seeking a Provider Relations Specialist to support provider relations and bill review activities.

The role involves analyzing medical bills, explaining processing methodologies to providers, and ensuring timely responses to inquiries, all while maintaining high-quality service for EK Health clients and partners. The position is full-time, non-exempt, remote with hours 8:00am–4:30pm PST, Monday–Friday.