Medical Billing Operations Analyst

Job Summary

Working full-time in the Eastern or Central Time Zone, the Medical Billing Operations Analyst will independently analyze incoming medical bills for compliance with usual and customary rates and fee schedules, manage provider disputes, and maintain accurate billing records.

Key responsibilities

• Review and analyze medical bills in the bill review system, ensuring compliance with client requirements across multiple states and lines of business
• Conduct independent research on usual and customary rates and fee schedule applications, providing quality reviews and training to co-workers
• Handle re-evaluation disputes and maintain provider and claim file accuracy

Required qualifications

• High School Diploma or equivalent
• 6-9 months of U&C bill review experience
• 9-12 months of fee scheduling bill review experience
• Experience with multi-jurisdictional bill review across 6+ fee schedule states
• Complete knowledge of CPT/ICD-9/HCPCS/NDS codes