Bill Review Services Associate II

Job Description
About Conduent
Through our dedicated associates, Conduent delivers mission-critical services and solutions on behalf of Fortune 100 companies and over 500 governments – creating exceptional outcomes for our clients and the millions of people who count on them.

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
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.

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

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.