Repricing Associate (Temporary)

OpenKrill; United States; Vor Ort; USD 33.000 - 40.000; Vollzeit

Benefits dieser Stelle

Competitive hourly pay

Fully remote work

Full-time temporary opportunity

Cross-training opportunities

Collaborative virtual environment

Skill development in medical coding

Zusammenfassung

Openkrill is seeking a detail-oriented Repricing Associate responsible for medical billing, coding verification, and accurate repricing of claims. This fully remote, temporary role in the United States supports regulatory compliance, appeals, and provider inquiries.

You will manage workflows across multiple systems, coordinate with vendors and provider networks, and maintain timely turnaround times in a fast-paced environment through Q2 2027.

Qualifikationen

• Experience in medical billing is required.
• Familiarity with ICD-10 and CPT-4 codes is expected.
• Understanding of CMS and Medicare requirements is necessary.
• Ability to navigate multiple software applications and screens.

Aufgaben

• Enter billing information and verify codes to support repricing.
• Investigate EDI claim rejections and resolve processing issues.
• Process billing reconsiderations and appeals with vendors and networks.
• Research payment discrepancies and respond to inquiries from providers and partners.
• Prepare reports and maintain accurate records across systems.
• Collaborate with internal teams, vendors, and provider networks.

Kenntnisse

Medical billing

Attention to detail

Regulatory compliance

Analytical skills

Communication skills

Time management

Independent and collaborative working

Remote work readiness

Customer service orientation

Ausbildung

College degree

Tools

Microsoft Word

Excel

Outlook

Teams

Slack

Zoom

Jobbeschreibung

This position is listed on behalf of a partner company, which manages all applications and next steps. Our partner is looking for a Repricing Associate (Temporary) based in the United States.

Overview

We are seeking a detail-oriented Repricing Associate to support medical billing operations, reimbursement accuracy, and workers' compensation claims processing. In this fully remote role, you will review billing information, verify medical codes, and ensure claims are repriced accurately in accordance with applicable regulations. You will manage reconsiderations and appeals, investigate payment discrepancies, and respond to inquiries from healthcare providers and external partners. Working across multiple systems, you will help maintain efficient workflows while meeting strict turnaround times and state-specific requirements. You will collaborate with internal teams, vendors, and provider networks to resolve billing issues and improve service quality. This temporary, full-time opportunity is expected to continue through the second quarter of 2027 and is well suited to a medical billing professional who values accuracy, organization, and responsive customer service.

Accountabilities

• Medical billing and data entry: Enter billing information and Medicare reporting data accurately while verifying ICD-10 and CPT-4 codes to support appropriate medical bill repricing.
• Regulatory compliance: Research and respond to inquiries within established turnaround times, ensuring compliance with applicable state laws and Medicare requirements.
• EDI claims processing: Investigate electronic data interchange (EDI) claim rejections, resolve processing issues, and apply manual repricing when necessary.
• Reconsiderations and appeals: Process and administer billing reconsiderations and appeals, coordinating with vendors and provider networks to support timely and accurate resolutions.
• Provider payment investigations: Research returned provider checks, investigate reimbursement inquiries, and process requests related to payment discrepancies.
• Reporting and documentation: Prepare comprehensive reports, maintain accurate records, and track inquiries and assigned tasks with minimal supervision.
• Vendor and network coordination: Participate in quarterly oversight meetings with preferred provider organization (PPO) networks and vendors to support effective collaboration and service quality.
• Cross-functional support: Cross-train on provider network responsibilities within the department and assist with additional operational duties as business needs evolve.
• Workflow and workload management: Prioritize assignments, navigate multiple systems simultaneously, and consistently meet deadlines and service standards.
• Customer service: Communicate professionally with internal and external stakeholders to resolve questions, clarify billing issues, and maintain positive working relationships.

Requirements

• Medical billing experience: Previous experience working in a medical billing environment is required.
• Education: A college degree or college-level education is preferred.
• Medical coding knowledge: A thorough understanding of billing and coding procedures, including familiarity with ICD-10 and CPT-4 codes, and a solid understanding of medical terminology.
• Medicare knowledge: Familiarity with Medicare and Centers for Medicare & Medicaid Services (CMS) requirements is necessary.
• Coding certifications: Relevant medical coding accreditations are an advantage.
• Regulatory awareness: Ability to apply state-specific requirements, compliance standards, and turnaround time expectations to medical bill repricing activities.
• Technical proficiency: Strong computer skills and the ability to navigate multiple software applications and screens efficiently.
• Microsoft Office and collaboration tools: Proficiency with Microsoft Word, Excel, Outlook, Teams, Slack, Zoom, and internet-based applications.
• Analytical and reporting skills: Ability to investigate billing and reimbursement discrepancies, prepare detailed reports, and manage assigned tasks with minimal guidance.
• Communication skills: Excellent written and verbal communication skills, with the ability to interact professionally with providers, vendors, and internal colleagues.
• Attention to detail: Strong organizational skills and a commitment to accurate data entry, coding verification, documentation, and claims processing.
• Time management: Ability to multitask, prioritize competing assignments, and meet deadlines in a fast-paced environment.
• Independent and collaborative working style: Comfortable working autonomously while contributing effectively to a virtual team.
• Adaptability: A flexible, self-motivated approach and a willingness to embrace changing priorities, learn new processes, and cross-train on departmental responsibilities.
• Remote work readiness: Reliable internet access and the ability to work effectively in a fully remote environment.
• Customer service orientation: Strong service skills and a proactive approach to resolving inquiries and addressing stakeholder concerns.

Benefits

• Competitive hourly pay: $24-$29 per hour, depending on qualifications, geographic location, and other applicable factors.
• Fully remote work: Work from anywhere in the United States.
• Full-time temporary opportunity: Expected duration through Q2 2027.
• Professional experience: Gain hands-on experience in medical bill repricing, workers' compensation claims operations, Medicare reporting, and reimbursement processes.
• Cross-training opportunities: Develop broader knowledge of provider network operations and related departmental responsibilities.
• Collaborative virtual environment: Work with internal teams, external vendors, and healthcare provider networks.
• Skill development: Strengthen your expertise in medical coding verification, regulatory compliance, claims reconsiderations, and billing issue resolution.

We appreciate your interest and wish you the best!