General Purpose
As a Bill Review Specialist, you are responsible for applying WellRithms’ reimbursement methodology through medical bill review. This position requires experience in medical billing and CPT coding and the ability to process medical bills timely and efficiently. Your previous experience in the group health or workers’ compensation fields is a plus. You will gain an understanding of the client’s protocols, workflow, and operational needs for all medical bill types.
Duties & Responsibilities
- Analyze medical bills and ensure the WellRithms reimbursement methodology is applied effectively.
- Perform a thorough review of the medical bill, records, and medical itemization to determine reasonable reimbursement.
- Review, process, and validate the correct use of medical billing CPT codes.
- Correct the errors and work with the staff and existing workflow to complete the medical review.
- Communicate with medical providers to get additional information for specific medical bills.
- Meet a minimum number of claims/bills reviewed per day while meeting quality assurance expectations.
- Other duties as assigned.
Qualifications
- High School diploma is required; some college is preferred.
- 2-3 years of experience in healthcare or a related field is preferred.
- Knowledge of CPT coding and medical terminology.
- Familiarity with HCFA150 and UB92 billing forms.
- Excellent written and oral communication skills.
- Ability to meet deadlines in a time sensitive environment.
- High comfort level with computers and software programs (MS Word, Excel, Outlook).
- CPC (Certified Professional Coding) education or certification is preferred.
