Senior Bill Review Analyst - Remote

Overview

As a Bill Review Analyst, you will pre-screen claims to identify unbundled charges and billing errors, resolving escalated cases that require coding expertise. You will perform in-depth reviews based on accepted billing practices and coding rules. With this information, you will provide timely insights to our internal teams and management to achieve savings for clients.

In Short

• Identify overcharges, unbundled codes and other discrepancies.
• Ensure codes are accurate and relevant and verify the correct use of modifiers.
• Stay updated on medical coding guidelines and regulations.
• Ensure adherence to national and industry billing standards.
• Work collaboratively with the Negotiation team to resolve claim issues.
• Communicate findings to clients with a Bill Review Report.
• Evaluate and respond to bill reconsideration requests.
• Communicate with providers to resolve billing discrepancies.
• Educate staff and clients on updates regarding codes/edits.
• Formulate and document department processes and policies.

Requirements

• 3+ years of auditing, claims, review and/or billing experience.
• Encoder Pro and/or Find-A-Code software experience.
• Experience in bill review and line charge verifications.
• Working knowledge of industry coding, ICD-10, CPT, HCPCS Revenue codes.
• Excellent communication skills, both verbal and written.
• Knowledge of CMS guidelines.

Benefits

• Generously subsidized company-sponsored Medical, Dental, and Vision insurance.
• Spending account options: HSA, FSA, and DCFSA.
• 401K with company match and immediate vesting.
• Flexible working environment.
• Generous Paid Time Off for vacation, sick leave, and holidays.
• Employee Assistance Program with counseling and referrals.
• Paid maternity and paternity leave.
• Pet insurance.
• Employee discounts on phone plans, car rentals, and computers.
• Community giveback opportunities with paid time off for philanthropic endeavors.