Senior Medical Pricing Specialist

Job Summary

To support a temporary assignment, the Senior Medical Pricing Specialist will oversee and coordinate the accurate processing of medical payments for Workers' Compensation claims, ensuring compliance with state fee schedules while working remotely or onsite in various locations across the United States.

Key responsibilities

• Manage the end-to-end processing of medical payments for Workers' Compensation claims in compliance with regulatory requirements
• Audit bill review vendors to ensure accuracy and compliance with contractual standards
• Collaborate with Claims staff to optimize workflows and resolve billing discrepancies

Required qualifications

• Minimum of 2 years of experience in medical billing, medical pricing, or Workers' Compensation claims processing
• Bachelor's degree from an accredited university or four additional years of related experience
• Strong understanding of medical terms, procedures, and the insurance industry
• Proficient in MS Office Suite and other business-related software
• Excellent written and verbal communication skills in English