CPC Certified Bill Review Analyst

Job Summary

Reviewing medical bills for discrepancies, the full-time remote Clinical Bill Review Analyst will analyze claims, collaborate with internal teams, and communicate findings to clients while ensuring compliance with regulatory standards.

Key responsibilities

• Review medical bills to identify billing, coding, and savings opportunities
• Analyze and resolve claim discrepancies requiring advanced expertise
• Collaborate with the Negotiation team to address complex claim issues and secure savings

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