Description

Summary :

Employee is a Lead Bill Reviewer who will assist the Bill Review Supervisor in a variety of functions related to the ultimate goals of the department.

Essential Duties and Responsibilities :

• Must be able to process all clients’ bills to serve as a team backup for all clients.
• Must be able to serve as a backup to the Bill Review Supervisor in day to day operations.
• Non-exempt employees must log all time worked in the Paylocity system including log-in and log-off time as well as lunch time.
• Codes medical bills into the company system with speed and accuracy, maintaining company production standards related to quantity and quality of output.
• Performs preliminary screening for appropriateness and medical necessity of services rendered.
• Uses CPT and ICD-10 codes, fee schedules, and other resource materials to determine appropriate reimbursement of billed services, including applicable fee schedule and / or repricing rational.
• Flags any problem bills.
• Communicates with clients and / or providers to clarify information
• Assists with bill review reporting functions (internal and external reports)
• May specialize in state specific or client specific areas of responsibility
• May assist is answering provider calls.
• May travel to other offices to assist with training
• May be called upon to assist with sales and marketing presentations

Requirements

Competency :

To perform the job successfully, an individual should demonstrate the following competencies :

• Design - Demonstrates attention to detail.
• Oral Communication - Speaks clearly and persuasively in positive or negative situations; Listens and gets clarification;

Responds well to questions.

• Team Work - Supports everyone's efforts to succeed.
• Quality - Demonstrates accuracy and thoroughness; Looks for ways to improve and promote quality; Applies feedback to improve performance;

Monitors own work to ensure quality.

Quantity - Meets productivity standards; Completes work in timely manner; Strives to increase productivity; Works quickl

Qualification Requirements :

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and / or ability required.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Excellent oral and written communication skills.

Education and / or Experience :

Last updated : 2024-05-20