Bill Review Services Associate II

You have an opportunity to personally thrive, make a difference and be part of a culture where individuality is noticed and valued every day.

Job Description

Must successfully complete and pass a background screen and/or a drug test.

Must be 18 or over with a Highschool diploma or GED

Job Track Description:

  • Performs tasks based on established procedures.
  • Uses data organizing and coordination skills to perform business support or technical work.
  • Requires vocational training, certifications, licensures, or equivalent experience.

General Profile

  • Expands skills within an analytical or operational process.
  • Maintains appropriate licenses, training, and certifications.
  • Applies experience and skills to complete assigned work.
  • Works within established procedures and practices.
  • Works with a moderate degree of supervision.

Functional Knowledge

  • Has developed skillset in a range of processes, procedures, and systems.

Business Expertise

  • Understanding of how teams integrate and work best together to support the achievement of company goals.

Impact

  • Impacts a team, by example, through the quality service and information provided
  • Follows standardized procedures and receives moderate supervision and guidance.

Leadership

  • Has no supervisory responsibilities.
  • Manages own workload.

Problem Solving

  • Uses existing procedures to solve standard problems without supervisory approval.

Interpersonal Skills

  • Exchanges information and ideas effectively.

Responsibility Statements

  • Audits payment determination, reconsiderations, and re-reviews on Medical Bill Data.
  • Assists in assigning procedure codes regarding complex issues and comprehensive exam codes.
  • Examines and adjusts lower-level technical bills, including high-level office visits, reports, and record reviews.
  • Analyzes medical reports, test results, and treatment plan to determine proper payment or reimbursement.
  • Maintains reference library of company and industry reimbursement policies
  • Conducts test studies for the compliance team, requiring high-quality results and strict deadlines.
  • Performs other duties as assigned.
  • Complies with all policies and standards.

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