Bill Review Team Lead – Workers Compensation

🔥 1 minute ago

🌵 Arizona, California, +2 more states – Remote

🌵 Arizona – Remote 🏄 California – Remote 🌺 Hawaii – Remote 🗽 New York – Remote

💵 $44k - $46k / year

⏰ Full Time

🟠 Senior

👻 Ghost score 0%

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EK Health Services Inc.

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 1998

💼 Consulting

🛡️ Insurance

🏥 Healthcare

Consulting • Insurance • Healthcare

EK Health Services Inc. is a comprehensive healthcare management company specializing in case management, medical bill management, and vocational services. They offer services such as discharge planning, utilization review, ergonomic evaluations, and Medicare set-aside services, ensuring excellence and efficiency in healthcare delivery. EK Health is committed to innovation and quality care, partnering with various organizations to enhance their offerings and support injured employees.

📋 Description

• Assist the medical bill review department staff daily under the direction of the BR Supervisor • Develop, train, and coach BR reviewers to build a high-performance culture • Manage daily inventory • Monitor, manage, and assign work/tasks to all bill review staff • Provide consistent performance feedback to bill review staff, no less than monthly/yearly • Assist Bill Review staff with questions • Analyze complex medical bills and make payment recommendations based on claim history, medical notes, usual and customary rates, statutory regulations, state laws and fee schedules, MPN/PPO contracts, coding guidelines, client instructions, and company policies and procedures • Maintain knowledge of client workflows and protocols • Work with management on resolution of client rejection files • Handle the client inquiry email box • Participate in quality assurance from initial receipt of bills through final payment • Communicate with medical providers to obtain information and resolve bill-specific issues • Respond to issues and drive problem resolution quickly • Participate in ongoing training • Maintain working knowledge of Ahshay and Billtelligent • Demonstrate positive behavior and lead by example • Support and assist all levels of the organization • Perform other duties as assigned

🎯 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. • 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

🏖️ Benefits

• Medical, Dental and Vision Insurance • 401K • Paid Time Off • Paid Holidays • Monthly internet stipend • Equipment provided