CompIQ

Analyst

• Reviews medical bills for appropriate, necessary, and any applicable unrelated charges.
• Reviews payment recommendations against applicable fee schedule allowances, regulatory or administrative charges, coding, and identifies billing errors to determine if fraud or inaccurate billing.
• Performs bill review functions in compliance with established client-specific rules and workflows that may change from time to time.
• Assists in the development and implementation of new audit/review methodologies to identify overpayments and underpayments to providers.
• Applies knowledge of provider billing and patient accounting practices to the research of client policy and data to reveal new overpayment recovery opportunities.
• Ensures productivity goals are met daily.
• Communicates audit and review issues and results to supervisors and managers.
• Performs other duties as assigned by supervisors and managers.
• Complies with all company guidelines, code of conduct, policies, and standards.

Medical Bill Review Analyst