New York Licensed Bill Review Specialist

Job Summary

To ensure accurate and compliant medical bill review within the New York workers' compensation and casualty environment, the full-time remote New York Licensed Bill Review Specialist will serve as a subject matter expert, manage bill review processes, and train staff on applicable regulations and procedures.

Key responsibilities

• Review medical bills for accuracy and compliance with New York Workers' Compensation Board regulations
• Configure and maintain bill review rules and workflows while collaborating with cross-functional teams
• Develop and deliver training programs for interdepartmental staff on regulatory requirements and procedures

Required qualifications

• At least 5 years of demonstrated expertise in New York Medical Treatment Guidelines (MTGs)
• Expertise in New York fee schedules and reimbursement methodologies
• Strong knowledge of CPT, HCPCS, and ICD-10 coding
• Experience with WCB dispute processes
• Understanding of medical narratives and attachments