Bill Review Specialist

Our Ideal Candidate

At WellRithms, we’re redefining medical reimbursement—and we need sharp, motivated professionals to help us lead the way. As a Bill Review Specialist, you’ll play a critical role in ensuring fair and accurate medical billing. You’ll apply WellRithms’ proprietary reimbursement methodology to review and process medical bills with precision. This is more than just a job—it’s an opportunity to deepen your expertise in medical billing and CPT coding while contributing to a mission-driven organization that values integrity and innovation. This role reports to the Bill Review Supervisor.

Responsibilities

• Analyze and evaluate medical bills to ensure accurate application of WellRithms’ reimbursement methodology within required timelines.
• Conduct detailed reviews of medical bills, supporting records, and itemized charges to determine fair and reasonable reimbursement.
• Verify and validate CPT, HCPCS, and other medical billing codes, ensuring correct usage and alignment with industry standards.
• Identify and correct billing discrepancies, collaborating with internal teams and leveraging established workflows to complete timely, high-quality reviews.
• Communicate directly with medical providers to request clarification, additional documentation, or corrections needed for accurate bill processing.
• Consistently meet daily productivity and quality assurance targets, maintaining accuracy in a fast-paced, time-sensitive environment.
• Support departmental needs by performing additional duties as assigned, contributing to continuous workflow improvement and operational efficiency.

Qualifications

• High School diploma is required; some college is preferred.
• 2-3 years of experience in healthcare or a related field is preferred.
• Knowledge of CPT coding and medical terminology.
• Familiarity with HCFA1500 and UB-04 billing forms.
• Excellent written and oral communication skills.
• Ability to meet deadlines in a time-sensitive environment.
• High comfort level with computers and software programs (MS Word, Excel, Outlook).
• CPC (Certified Professional Coding) education or certification is preferred.