Description
Please note: At this time, we are not accepting or considering applicants residing in California (CA), New York (NY), or
Hawaii (HI).
Under the direction of BR Supervisor, the Bill Review Team Lead is responsible for assisting the medical bill review department staff daily. Team Lead is also responsible for building a high-performance culture by developing, training, and coaching the BR reviewers. Bill Review requires an affinity for medical billing, coding and claims, and a meticulous attention to detail to identify errors and discrepancies.
Position Specifics: Full-time, Exempt position; remote Monday through Friday, 7am-4pm any time zone (PST time during training)
The job responsibilities will include, but are not limited to:
- Manage daily inventory
- Monitoring, managing, and assigning work/tasks to all bill review staff (regardless of role)
- Providing consistent, but no less than monthly/yearly performance feedback to all bill review staff
- Assisting Bill review staff with questions
- Accurately and appropriately analyze complex medical bills and make payment recommendations based on claim history, medical notes, usual and customary rates (UCR), statutory regulations including state laws and fee schedules, available MPN/PPO contracts, coding guidelines, client instructions, and company policies and procedures
- Maintain knowledge of all client workflows/protocols (indexing, processing rules, etc.)
- Work with management team on resolution of client rejection files
- Handle client inquiry email box
- Participate in the quality assurance (QA) process from initial receipt of bills through final payment
- Communicate with medical providers to obtain needed information and resolve bill-specific issues
- Respond to issues and drive problem resolution in a quick turn- around time
- Participate in ongoing training to enhance job skills and knowledge
- Continuous working knowledge of Ahshay and Billtelligent
- Demonstrate positive behavior and lead by example to improve work environment
- Support and assist all levels of the organization
- Other duties as assigned
Pay & Perks
- Pay $44K - $46K based on experience, education and location
- Medical, Dental and Vision Insurance
- 401K
- Paid Time Off
- Paid Holidays
- Monthly internet stipend
- Equipment provided
Requirements
- High School Diploma required
- 3+ years of experience in complex Workers' Compensation Bill Review with customer service exposure.
- Knowledge of medical terminology, CPT codes, and DRG.
- Ability to read, analyze, and interpret technical procedures, medical reports, state laws and fee schedules.
- CPC (Certified Professional Coding) coursework or certification a big plus.
- Experience supervising staff members.
- Demonstrate the ability to manage people in a fast pace environment
- Good Written and Oral Communication Skills
- Good Interpersonal Skills
- Good Organization Skills
- Good comfort level with computers and computer programs (MS Word, MS Excel, Email)
- Ability to work independently with minimal supervision
- Ability to meet deadlines in a high pressure, time sensitive environment
- Ability to lift up to 20 lbs.
Physical Requirements:
Candidate must be able to sit the majority of an 8-hour day except for lunch and break times. Candidate must be able to keyboard the majority of an 8-hour day except for lunch and break times. Candidate must have manual dexterity. Candidate must be able to speak on the telephone intermittently throughout the day. Candidate must be able to read and write English fluently. Candidate must be able to provide and confirm safe home office environment. Home office must be HIPAA compliant.
*Requires DSL, fiber or cable internet connection from home 100 Mbps preferred or better. *Skills Required
- High school diploma
- 3+ years of experience in complex Workers’ Compensation bill review with customer service exposure
- Knowledge of medical terminology, CPT codes, and DRG
- Ability to read, analyze, and interpret technical procedures, medical reports, state laws, and fee schedules
- CPC coursework or certification
- Experience supervising staff members
- Ability to manage people in a fast-paced environment
- Good written and oral communication skills
- Good interpersonal skills
- Good organizational skills
- Comfort with computers and programs including Microsoft Word, Microsoft Excel, and email
- Ability to work independently with minimal supervision
- Ability to meet deadlines in a high-pressure, time-sensitive environment
- Ability to lift up to 20 pounds
- Fluent English reading and writing
- Ability to provide and confirm a safe, HIPAA-compliant home office
- DSL, fiber, or cable internet connection; 100 Mbps preferred or better
What We Do
EK Health Services Inc. is a leading national workers’ compensation managed care organization that partners with companies, insurers, healthcare professionals, and patients to resolve complex issues surrounding work comp healthcare. They provide a comprehensive line of managed care solutions, including medical case management, utilization and peer review, and medical bill review, focusing on restoring quality of life for injured workers through innovative, cost-effective solutions.
