Workers Compensation Claims Examiner

Description: Please note: At this time, we are not accepting or considering applicants residing in California (CA), New York (NY), orHawaii (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) Job Responsibilities 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.