Workers Compensation Bill Review Specialist

Job Summary

Analyzing and processing complex medical bills, the full-time Workers Compensation Bill Review Specialist will work remotely to make payment recommendations, ensure accurate coding, and participate in quality assurance while providing excellent customer service to clients and medical providers.

Key responsibilities

• Accurately analyze complex medical bills and make payment recommendations based on various factors including claim history and coding guidelines
• Review and verify the correct use of medical billing codes, reporting any discrepancies to the Bill Review Manager
• Participate in the quality assurance process and communicate with medical providers and clients to resolve billing issues

Required qualifications

• High School Diploma required; some college or a college degree preferred
• 2+ years of experience in complex Workers' Compensation Bill Review with customer service exposure
• Knowledge of medical terminology, CPT codes, and DRG
• Experience with Hospital Bill Review is a plus
• CPC (Certified Professional Coding) coursework or certification is a significant advantage