Medical Bill Review Analyst

Job Summary

A company is looking for a Medical Bill Review Analyst.

Key Responsibilities:

• Process routine to complex claims and electronic work queues in accordance with company policies and procedures
• Interpret and process systems edits using Documentation Guidelines and state fee schedules
• Research information using State Reference Guides as a resource and follow client protocols and implementation dates

Required Qualifications:

• High School Diploma or equivalent
• Certified Professional Coder (CPC) designation from the American Academy of Professional Coders
• 2+ years of recent experience with CPT, CPT Modifiers, HCPCS, ICD-9, ICD-10 coding guidelines
• 2+ years of experience in Evaluation and Management, specifically related to 2021 AMA CPT changes
• 3+ years of experience in claims processing for medical bill review or Clinical Code Review in Worker's Compensation