
OPEN POSITIONS
Bill Review Supervisor
General Purpose
The Bill Review Supervisor is responsible for supervising medical bill review processors. Supervisor 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. The Supervisor is also responsible for evaluating the daily workflow and providing feedback to the VP of Claims and VP of Operations to improve overall efficiency.
Duties & Responsibilities
-
Supervise and evaluate personnel on the Bill Review team.
-
Accurately and appropriately analyze complex medical bills and make payment recommendations based on claim history, medical notes, statutory regulations including state laws and fee schedules, coding guidelines, client guidelines, and company policies and procedures.
-
Participate and help lead the quality assurance (QA) process, BR processors and workflow.
-
Respond to issues and drive problem resolution in a quick turn- around time.
-
Participate in ongoing training to enhance job skills and knowledge.
-
Maintain monthly statistical information regarding employee performance and perform annual reviews.
-
Maintain monthly statistics regarding client data.
-
Continuous working knowledge of Harmony/ Melody and other BR related systems.
-
Demonstrate positive behavior and lead by example to improve work environment.
-
Support and assist all levels of the organization.
-
Work closely with sales regarding workflow of test bills and provide quick results and strong savings for all submissions.
Qualifications
-
5+ years of experience in complex Workers' Compensation Bill Review with customer service exposure.
-
Knowledge of medical terminology, CPT, DRG, Revenue, HCPC, ICD9/10 codes
-
Ability to read, analyze, and interpret technical procedures, medical reports, state laws and fee schedules.
-
CPC (Certified Professional Coding) coursework or certification is a big plus.
-
Experience supervising staff members.
-
Demonstrate the ability to manage people in a fast-paced environment.
-
Good Written and Oral Communication Skills
-
Good Interpersonal Skills
-
Bachelor’s degree preferred but not required
-
Good interpersonal and organizational skills
-
Strong oral, written and interpersonal skills.
Legal Assistant
General Purpose
The Legal Assistant position is a role that will report directly to the Paralegal for our Missouri Work Comp program. The Legal Assistant position requires the ability to communicate effectively with partners, customers, and WellRithms leadership. In addition, this position must be able to maintain and organize hearing files, provide support to paralegal/counsel, review pleadings, letters, notices, and follow-up routinely on existing hearing cases. This individual will work closely with the Paralegal and other internal teams to ensure all deadlines surrounding workers’ compensation hearing cases are completed in a timely manner.
Duties & Responsibilities
-
Review pleadings, letters, and hearing notices.
-
Ability to interpret policies and procedures and communicate effectively.
-
Demonstrate ability to set priorities and strong attention to detail.
-
Provide practice support to attorneys and paralegals to ensure deadlines are met.
-
Create and organize case specific databases and maintain case custodian lists on assigned cases.
-
Highly self-motivated, with the ability to partner effectively with cross functional teams to achieve desired business results.
-
Implement document dispute holds and review strategy prior to distribution.
-
Specific attention to detail and coordinate with paralegal, secretary, and hearing team.
-
Perform administrative duties including monitoring, responding to email, data entry, and maintaining organized systems for tracking tasks and deadlines.
Qualifications
-
Minimum of three (3) years of legal experience working with a firm.
-
Bachelor’s degree preferred but not required.
-
Good interpersonal and organizational skills
-
Demonstrate the ability to use MS Office products and other corporate software as required.
-
Ability to work independently.
-
Ability to meet deadlines.
-
Ability to update spreadsheets, claim/bill files and email correspondence.
-
Proficient in MS Office items (Excel, Word, Power point).
-
Strong oral, written and interpersonal skills including courteous telephone etiquette.