Insurance Collections Specialist
Gastro Health
Medical Bill Review Analyst
CompIQ
full-time
Posted on:
Location: South Carolina • 🇺🇸 United States
Visit company websiteJob Level
Mid-LevelSenior
About the role
- 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.
Requirements
- High School Diploma / GED (or higher)
- 5+ years of experience with processing Workers Compensation bills
- Intermediate proficiency with Microsoft Word, Microsoft Excel and Microsoft Outlook
- Advanced knowledge in Workers Compensation rules/regulations
- Ability to prioritize and balance multiple priorities and projects
- Ability to identify, understand, and drive resolution of complex critical issues
- Ability to communicate ideas clearly and concisely to leadership (Lead, Director, and VP where appropriate) and technical teams
- Bachelor's degree in Business, Health Administration, or related field (preferred)
- Associate degree in medical coding or related field (preferred)
- Certified Professional Coding (CPC) License (preferred)
- Medical Billing experience (preferred)
