Clinical Bill Review Analyst

Job Summary

Reviewing medical bills and identifying billing discrepancies, the full-time Clinical Bill Review Analyst will work remotely to analyze claims, collaborate with negotiation teams, and provide actionable insights to support client outcomes.

Key responsibilities

• Review medical bills to identify appropriate billing, coding, and savings opportunities
• Analyze and resolve claim discrepancies that require advanced expertise
• Communicate findings to clients through detailed Bill Review Reports and assist with complex inquiries

Required qualifications

• 3+ years of auditing, claims review, and/or billing experience within a healthcare organization
• CPC and/or CIC certification
• Working knowledge of industry coding, including ICD-10, CPT, and HCPCS Revenue codes
• Knowledge of CMS guidelines
• Experience with DRG validation is a plus