Job Summary
EK Health Services continues to experience growth and is recruiting for a Remote Bill Review Specialist!
Reporting to the Bill Review Supervisor, a Bill Review Specialist is responsible for accurately analyzing and processing large, complex medical bills. Bill Review requires an affinity for medical billing, coding and claims, and a meticulous attention to detail to identify errors and discrepancies. 2+ years of experience in complex Workers' Compensation Bill Review with customer service exposure. CPC (Certified Professional Coding) coursework or certification a big plus.
Position Specifics: Full-time, non-exempt position; remotely from home
The job responsibilities will include, but are not limited to:
o Accurately and appropriately analyze complex medical bills and make payment recommendations based on claim history, medical notes, usual and customary rates (UCR), statutory regulations including state laws and fee schedules, available MPN/PPO contracts, coding guidelines, client instructions, and company policies and procedures.
o Reviews and verifies the correct use of medical billing codes and reports the detection of improper use of billing codes to BR Manager.
o Participate in the quality assurance (QA) process from initial receipt of bills through final payment.
o Protect system integrity: monitoring and correcting duplications and inaccurate/outdated data.
o Communicate with medical providers to obtain needed information and resolve bill-specific issues.
o Communicate directly with clients, offering excellent customer service by responding to and answering their questions quickly and professionally
o Participate in ongoing training to enhance job skills and knowledge.
o Other duties as assigned.
Requirements
o High School Diploma required, some college or college degree preferred
o 2+ years of experience in complex Workers' Compensation Bill Review with customer service exposure
o Knowledge of medical terminology, CPT codes, and DRG
o Ability to read, analyze, and interpret technical procedures, medical reports, state laws and fee schedules
o Hospital Bill Review experience a plus
o CPC (Certified Professional Coding) coursework or certification a big plus
o Excellent Written and Oral Communication & Interpersonal Skills
o Strong Organization Skills
o High comfort level with computers and computer programs (MS Word, MS Excel, Email)
o Ability to meet deadlines in a high pressure, time sensitive environment
Physical Requirements:
Candidate must be able to sit the majority of an 8-hour day except for lunch and break times. Candidate must be able to keyboard the majority of an 8-hour day except for lunch and break times. Candidate must have manual dexterity. Candidate must be able to speak on the telephone intermittently throughout the day. Candidate must be able to read and write English fluently. Candidate must be able to provide and confirm safe home office environment. Home office must be HIPAA compliant.
*Requires DSL, fiber, or cable internet connection from home 10 Mbps preferred or better. *
EK Health Services has built a reputation for offering superior, goal-oriented Workers' Compensation case management, utilization review, and bill review services. Our emphasis on medical excellence, superior service, impartial reporting, and case resolution is the driving force behind our consistent annual growth. Employees are provided with competitive compensation and benefits, including but not limited to medical, dental, vision, PTO, and 401k.
EK is an equal opportunity employer and makes all employment decisions on the basis of merit. EK does not practice, tolerate, or condone unlawful discrimination based on any protected status or the perception of such status.
