Senior Medical Bill Auditor (Workers' Comp)

AvonRisk; Rocklin (CA); On-site; USD 36,000 - 39,000; Full time

Benefits offered by this job

Medical benefits

401(k) with match

Paid time off

Career development

Employee assistance

Job summary

AvonRisk is seeking a Medical Billing Specialist in California who will process and audit workers’ compensation bills with accuracy, using CPT and ICD coding and appropriate fee schedules. The role involves screening for medical necessity, pricing bills, and communicating with providers to clarify information.

The ideal candidate will have a GED or high school diploma and at least one year of medical billing data entry experience, plus a 40-hour Medical Bill Reviewer designation with ongoing CE

Qualifications

• High school diploma or GED plus data entry/medical billing experience.
• Minimum one year data entry/medical billing; two years bill review in a workers’ comp environment.
• Medical Bill Reviewer designation – 40 hour initial certification plus 16 hours continuing education every 2 years.

Responsibilities

• Code medical bills using CPT/ICD and fee schedules with speed and accuracy.
• Screen for appropriateness and medical necessity of services rendered.
• Price hospital and surgery bills to applicable fee schedules and process reconsideration requests as assigned.
• Communicate with clients/providers to clarify information and may assist in answering provider calls.

Skills

Attention to detail

Oral communication

Teamwork

Quality assurance

Productivity

Education

High school diploma or GED

Tools

Word processing

Spreadsheets

Database software

Job description

AvonRisk is seeking a Medical Billing Specialist in California who will process and audit workers’ compensation bills with accuracy, using CPT and ICD coding and appropriate fee schedules. The role involves screening for medical necessity, pricing bills, and communicating with providers to clarify information.

The ideal candidate will have a GED or high school diploma and at least one year of medical billing data entry experience, plus a 40-hour Medical Bill Reviewer designation with ongoing CE