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OPEN POSITIONS

Bill Review Specialist

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The Bill Review Specialist is responsible for applying WellRithms’ reimbursement methodology through medical bill review.  This position requires experience in medical billing and CPT coding, as well as the ability to process medical bills timely and efficiently.  Additionally, the Bill Review Specialist must be able to effectively communicate nuanced details regarding specific bills to leadership and clinical staff, when necessary.  Previous experience in the group health or workers’ compensation fields is a plus.

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Duties & Responsibilities

  • Review, process and validate the correct use of medical billing CPT codes.  If there are CPT coding errors correct them and work with the staff and existing workflow to complete the medical review. Review

  • Analyze large and small medical bills and make sure WellRithms reimbursement methodology is applied effectively.  Thorough review of the medical bill, records and medical itemization may be required to determine reasonable reimbursement.

  • Bill Reviewer must be effective in understanding client’s protocols, workflow, and operational needs for all medical bill types.

  • Participate in ongoing training to increase job skills and education.

  • Must be able to communicate with medical providers to get additional information if necessary for specific medical bills.

  • Collaborate effectively with leadership and team members regarding medical bill review and client workflow. 

  • Bill Reviewer is required to meet a minimum number of claims/bills reviewed per day while meeting quality assurance expectations.

  • Maintains punctual, regular, and predictable attendance.

  • Works collaboratively in a team environment with a spirit of cooperation.

  • Respectfully takes direction from manager.

  • Other duties as assigned.

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Qualifications

  • High School diploma is required; some college is preferred.

  • 1 year of experience in healthcare or a related field is preferred.

  • Knowledge of CPT coding and medical terminology.

  • Familiarity with HCFA150 and UB92 billing forms.

  • Proven ability to organize and plan complex tasks.

  • Excellent written and oral communication skills.

  • Upbeat, friendly, and professional.

  • Ability to meet deadlines in a time sensitive environment.

  • Ability to review a medical billing form to identify important details and requirements for processing.

  • High comfort level with computers and software programs (MS Word, Excel, Outlook).

  • CPC (Certified Professional Coding) education or certification is a plus but not required.

  • Bill Reviewer will sit 80-100% of the time and type/ research 100% of the time.

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