Remote Workers' Comp Bill Review Analyst

Ethos Risk Services; Irving (TX); Remote; USD 55,000 - 75,000; Full time

Benefits offered by this job

100% remote

Benefits package including medical/d/d

401(k) Matching

Job summary

Ethos Risk Services is seeking a full-time Bill Review Specialist (REMOTE) to review, audit, and process workers' compensation medical bills while ensuring compliance with state fee schedules, regulatory requirements, and client-specific guidelines.

The ideal candidate is analytical, organized, and capable of delivering accurate, high-quality work in a fast-paced environment from a remote setting.

Qualifications

• Minimum 3–5 years of workers' compensation bill review experience.
• Proficient in CPT, ICD-10, HCPCS coding and fee schedules.
• Experience with specific billing disputes and client guidelines is preferred.

Responsibilities

• Analyze Medical Bills – Review and adjudicate hospital, ASC, DME, pharmacy, transportation, home health and other bills.
• Research Provider Appeals – Investigate appeals, reconsiderations, and disputes per fee schedules and regulations.
• Prepare Reimbursement Determinations – Draft clear written decisions and explanations.
• Communicate with Providers – Respond to inquiries regarding reimbursement decisions and billing questions.
• Support Cross-Functional Teams – Collaborate with Account Management and internal stakeholders.

Skills

Analytical thinking

Attention to detail

Communication

Remote work

Education

High school diploma

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 while ensuring compliance with state fee schedules, regulatory requirements, and client-specific guidelines.

The ideal candidate is analytical, organized, and capable of delivering accurate, high-quality work in a fast-paced environment from a remote setting.