Job Description
The Reny Company's bill reviewer is a professional who combines experience in health insurance and medical billing with business insight and a passion for great service. Purpose of this role is to support Claims by analyzing medical, hospital, durable medical equipment, pharmacy, home health, etc. bills and records/reports to determine billing accuracy and appropriateness. This support is achieved by utilizing intelligent software and by understanding and applying knowledge of medical code billing and claims processing rules and regulations, billing practices, code sets, and state and Medicare adjustment reimbursement principles, knowledge of WC fee schedules. Support is also achieved by providing education and training regarding provider billing and documentation, identifying and bringing to management's attention any unusual or emerging procedures or billing anomalies. The bill reviewer will ensure the highest level of accuracy of data entry into our bill review system for claims processing.
PLEASE DO NOT APPLY IF YOU DON'T HAVE THE EDUCATION AND MEDICAL BILL REVIEW EXPERIENCE
Experience Requirements:
Two or more years of experience in a medical bill review analyst position preferred. Medical coding knowledge needed. Prior experience in a payer environment working with claims systems and bill review software is a plus.
Production Requirements:
• Based upon situation or state specific issues meet 98% accuracy, 10,000+ keystrokes per hour
Responsibilities:
• Process medical bills for workers' compensation, Texas non subscription, maritime, occupational accident, and liability claims
• Data entry into system applying usual and customary, worker's compensation and liability ground rules and fee schedules
• Continuous enhancement of working knowledge of medical forms such as CMS-1500, UB-92, UBO4/DWC-9/DWC-10
• Increase knowledge of coding principles CPT, ICD-9 / ICD-10, DRG, Revenue codes
• Responsible for processing a minimum quota per day with an error rate of 98% or better
• Increase knowledge on pre-authorization guidelines in order to pay/deny bills accordingly
• Ensure all bill processing is specific to client requests
• May be asked to perform other duties as management deems necessary
Education/Qualifications:
Associates degree or equivalent work experience Certified Professional Coder certification such as CCA. CCS, CCS-P, CPC, CPC-P from a generally recognized professional organization such as AHIMA or AAPC
• Experience with Medical Bill Review preferred
•High school diploma or equivalent, college preferred
• Two to three years of medical claims experience
• Trained in ICD10 preferred
• Workers’ Compensation experience preferred
• Fee Schedule knowledge and Medicare experience preferred
• Knowledgeable of Excel, Word, Outlook, etc.
• Ability to multi-task effectively while meeting or exceeding aggressive deadlines
• Ability to work independently and in a team environment
The Reny Company is an Equal Opportunity Employer. In order to provide equal employment and advancement opportunities to all individuals, employment decisions at The Reny Company will be based on merit, qualifications and abilities. Except where required or permitted by law, employment practices will not be influenced or affected by an applicant's or employee's race, color, religion, sex, national origin, ancestry, citizenship, age, handicap or disability, marital status, medical condition or any other characteristic protected by applicable law.
THIS IS NOT A REMOTE POSITION
ONLY THOSE WITH RELEVANT EDUCATION AND MEDICAL BILL REVIEW EXPERIENCE NEED APPLY
\nCompany DescriptionThe Reny Company is a rapidly growing health care cost containment company, helping clients save money and better navigate our changing health care system. We specialize in medical bill review and negotiation services for workers compensation, non-subscribers, third party administrators, and maritime clients.
The Reny Company is a rapidly growing health care cost containment company, helping clients save money and better navigate our changing health care system. We specialize in medical bill review and negotiation services for workers compensation, non-subscribers, third party administrators, and maritime clients.
...Collins Machine Works is looking for a Wire EDM Machinist that will be responsible for setting up, operating and troubleshooting Wire EDM machines to produce precision components. The ideal applicant must have a strong mechanical aptitude and the ability to read and interpret...
...on state regulatory and legislative matters. This role monitors and analyzes state legislative and regulatory initiatives affecting FINRA and the securities industry, delivering actionable intelligence to senior leadership. The position manages critical stakeholder relationships...
...this position will require independent judgment to plan, prioritize and organize a diversified workload, and recommend changes in office practices or procedures. Key Responsibilities Assist with work products such as tax analysis, client and/or government correspondence...
...someone who can take a shoot and elevate it into content that actually moves people. You'll cut across formats: social content, brand films, event recaps, interviews, and paid ads.2+ years of professional editing experienceProficiency in Adobe Premiere Pro and After...
Renewal by Andersen is seeking a motivated, high energy Outside Sales Rep to join our sales team. In-home sales of Renewal by Andersen windows and patio doors as well as various lines of entry doors. The sales process will be in the form of a consultative approach. No...