Workers' Compensation Bill Review Auditor

Summary of Functions: Under moderate supervision, this position is responsible for analyzing incoming medical bills for fee schedule or usual and customary application as well as PPO interface, while meeting contractual client requirements. This position is also responsible for producing a final review for recommendation of payment to the client. In this role, it is expected to maintain an acceptable productivity, with speed and a level of accuracy as determined by IMS standards. Essential Duties and Responsibilities:

• Utilize fee schedules, online documents, client instructions, and other training material to properly review medical bills
• Research usual and customary fee schedule applications and system interface as appropriate
• Proactively identify system and or bill review issues and provide feedback to coder
• Update claims and vendor information
• Answer client or provider inquiries, as they arise
• Utilize and interpret supporting documentation attached to medical bills
• Application of appropriate fee schedule and PPO contracted reductions
• Other duties as assigned

Qualifications:

• Associate Degree preferred
• California Certification for Medical Bill Coding preferred
• At least 5 years reviewing medical bills and coding in Workers Compensation
• Knowledge of CMS 1500, CPT, ICD9, and HCPCS
• Strong detailed analytical skills
• Computer literate, Intermediate MS Excel and Word
• Proficiency with 10-key pad at 9000+kph
• Strong written and verbal communication skills
• Ability to sit for long periods of time
• Must be authorized to work in the United States
• Must be willing to do a Drug and Background Check

Physical Requirements: Prolonged sitting and computer use. Frequent use of hands and fingers. Occasional lifting up to 20 lbs. Ability to meet vision requirements including close and distance vision Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions. Benefits: 401(k) with employer matching Health, Dental, and Vision Insurance Health Savings Account (HSA) Flexible Spending Account (FSA) Life Insurance Paid Time Off Company provided equipment: Computer, Monitors, Etc. Pay: $50,000 to $65,000 depending on experience Pay: $50,000.00 - $65,000.00 per year Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Vision insurance
• Work from home

Application Question(s):

• Do you have at least 5 years experience reviewing Medical Bills and coding in Workers' Compensation?
• Are you willing to take a drug test, in accordance with local law/regulations?

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