Sr Bill Review Analyst

MedRisk LLC

About The Position

Under moderate supervision, this position is responsible for analyzing incoming medical bills for fee schedule or usual and customary application as well as PPO interface while meeting contractual client requirements. This position is also responsible for producing a final review for recommendation of payment to the client. Candidate will be required to maintain an acceptable productivity as well as speed and level of accuracy as determined by company standards and bill review manager. Pay rate is commensurate with experience.

Requirements

High School diploma or equivalent
Proficiency as a Bill Review Analyst with three or more years previous experience in medical bill review or coding (workers’ compensation is a plus)
Proficiency with 10-key pad at 9000+ kph or equivalent bill processing rate
Ability to work in a high production environment while meeting productivity and quality standards
Proficiency with Microsoft Word and Excel
Strong knowledge of Medical Terminology and CPT / ICD-9 / ICD-10 coding – Knowledge of multi-state fee schedules preferred.

Nice To Haves

Experienced Medical Bill Reviewer Designation
Strong written and verbal communication skills
Certification in Coding
Certified Professional Coder (CPC) designation a plus

Responsibilities

Auditing and approving workers compensation and/or no fault medical bills in the Medata system
Analysis and review of different fee schedule states and clients
Utilize Fee Schedules, Online Documents, Client instructions and other training material to proper review medical bills
Research usual and customary/fee schedule applications and system interface as appropriate
Provide quality review on work as specified by Lead/Supervisor
Proactively identify system and/or bill review issues and provide feedback to supervisors or manager
Review of medical records and strong understanding of medical terminology.
Review and understanding of prior billing history for each bill within our systems applications.
All bills require review by a tenured and experienced reviewer with bill review knowledge and understanding of our systems applications.
Adhering to the tight Turn Around Time on the review of bills, per the client’s request and needs.
Other duties as assigned