Remote Provider Relations & Bill Review Specialist

Ek-Health-Services-Inc.-1; Sparks (NV); Remote; 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 is seeking a Provider Relations Specialist to join the Bill Review team. You will develop and maintain provider relationships, analyze medical bills, and ensure accurate pricing in a fast-paced environment.

Remote, full-time role with 8:00 AM–4:30 PM PST hours. Excellent communication with providers, clients, and colleagues is essential; training and growth opportunities are provided.

Qualifications

• Knowledge of medical terminology, CPT codes, and DRG.
• Strong written and oral communication & interpersonal skills.
• 2+ years of experience in complex Workers' Compensation Bill Review with customer service exposure.

Responsibilities

• Analyze medical bills based on claim jurisdiction, UCR, regulations, contracts, coding guidelines and company policies.
• Explain the bill processing methodology to providers and re-pricing mechanics.
• Receive provider calls, emails and voicemails and respond within 48 hours.
• Monitor the bill review process from initial receipt to final payment.
• Verify correct use of medical billing codes and report improper coding.
• Collaborate with the Bill Review team on QA issues.
• Communicate with providers, clients and adjusters professionally and promptly.
• Participate in ongoing training and other duties as assigned.

Skills

Medical terminology

CPT coding

DRG knowledge

Written and verbal communication

Interpersonal skills

Customer service

Education

High School Diploma

Job description

EK Health is seeking a Provider Relations Specialist to join the Bill Review team. You will develop and maintain provider relationships, analyze medical bills, and ensure accurate pricing in a fast-paced environment.

Remote, full-time role with 8:00 AM–4:30 PM PST hours. Excellent communication with providers, clients, and colleagues is essential; training and growth opportunities are provided.