AssuredPartners

  • Sr. Bill Review Analyst

    Job ID
    2019-5517
    # of Openings
    1
    Category
    Workers Compensation
    Location
    US-CA-Torrance
  • Overview

    Process Workers’ Compensation medical bills in the Smart Advisor Bill Review Software application to reprice bills to the OMFS (Official Medical Fee Schedule) and/or contracted PPO rate, along with overseeing production of the unit in the absence of the Supervisor.

    Responsibilities

    Process Workers’ Compensation medical bills in the Smart Advisor Bill Review Software application to reprice bills to the OMFS (Official Medical Fee Schedule) and/or contracted PPO rate, along with overseeing production of the unit in the absence of the Supervisor.

     

    ESSENTIAL DUTIES AND RESPONSIBILITIES include the following:

    • Process Workers Compensation bills to OMFS and any applicable contracts.
    • Audit E-bills and release for payment.
    • Complete Bill Track daily and correct/release any pends.
    • Assist Supervisor when needed to run pricing import and payment export.
    • Assist with training, incoming, QA and outgoing mail.
    • Assist with troubleshooting system problems, releasing re-evals from audit queue, process test client bills and oversee production unit in the absence of the Supervisor.
    • Assist customer service reps with call coverage or questions on claims.
    • Complete all continuing education requirements.
    • Other duties as assigned.

     

    MINIMUM SUGGESTED QUALIFICATIONS:

    • Minimum of three (3) years’ experience with Bill Review.  
    • Minimum of four (4) years’ experience adjusting California workers' compensation medical bills.
    • Designated as a medical bill reviewer by a medical billing entity or by an insurer.
    • Excellent verbal and written communication skills.
    • Must be organization and detailed orientated.  

     

    SOFTWARE: Proficient in Microsoft Outlook, Excel, PowerPoint and Word. Adept at accessing business data from the Internet when required.

     

    PHYSICAL DEMANDS: While performing the duties of this job, the employee is regularly required to use manual dexterity, handle, or feel objects, tools, or controls; reach with hands and arms; and speak or hear. The employee frequently is required to walk, stand and sit. Position requires employee to frequently exert up to 10 pounds of force to move objects and occasionally exert up to 20 pounds of force to move objects. 

     

    REASONING ABILITY: Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, verbal, diagram, or schedule form.

     

    WORK ENVIRONMENT: Normally not exposed to conditions that are discomforting or disagreeable.

     

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