Analyst, Senior Bill Review Services

Location
Dublin, Ohio
Salary
Not Specified
Posted
Apr 04, 2018
Closes
Jun 03, 2018
Ref
R1154#GIJ--York.1
Job Type
Not Specified
Career Level
Not Specified

York Risk Services Group is a premier provider of insurance, risk management, alternative risk, pool administration and claims management solutions to clients across hundreds of industries. Recently named by Forbes as one of "America's Best Midsized Companies 2017" We firmly believe that our employees drive the success of the company. With success in mind as the ultimate goal, we strive to create and provide an environment that offers challenging, stimulating and financially rewarding opportunities.

Job Description

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JOB SUMMARY:

Job duties for this position center on the ability to provide payment recommendations for the billings from medical providers, for medically related services, delivered to workers who are injured on the job.

ESSENTIAL JOB RESPONSIBILITIES:

  • Responsible for reviewing medical bills in accordance to the fee schedule, U&C and/or internal processing guidelines and for data accuracy
  • Confirm and apply utilization review authorization/denial when applicable
  • Utilize and interpret supporting documentation attached to medical bills from providers (reports, etc.)
  • Complete a minimum standard of 130 reviews per day
  • Reviews all bills in excess of a specific dollar threshold as determined by management
  • Other duties as assigned

SUPERVISORY RESPONSIBILITIES:

SUPERVISION RECEIVED:

  • This position reports to the Team Lead, Unit Manager or Director, Bill Review Services

SUPERVISION EXERCISED:

  • NA

QUALIFICATIONS:

EDUCATION:

  • BS/BA or Equivalent Work Experience/Education

EXPERIENCE:

  • 1 to 2 years of professional work experience preferred
  • Previous work in medical claims or medical billing

SKILLS/ABILITIES:

  • Strong comprehension and analytical skills
  • Ability to multi-task based on the review types
  • Ability to think outside the box

KNOWLEDGE:

  • Official Medical Fee Schedule
  • CPT Codes (Current Procedural Terminology)
  • Medical Terminology

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