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Medical Itemized Bill Review Specialist

Medical Itemized Bill Review Specialist

Blue SignalRochester, MN
30+ days ago
Job type
  • Full-time
Job description

Medical Itemized Bill Review Specialist

Our client is a high-growth, venture-backed startup, dedicated to revolutionizing the U.S. healthcare system. They encourage collaboration among individuals with diverse backgrounds and ideologies to drive innovation. If you’re passionate about leveraging cutting-edge technologies to make a significant impact on U.S. healthcare, we invite you to join this company’s mission-driven team.

As a Medical Itemized Bill Review Specialist, you will play a crucial role in automating medical claim audits. You will review claim forms, patient medical records, and audit results to train their platform. The primary responsibilities include identifying coding / billing violations, auditing revenue codes against clinical documentation, and ensuring accuracy in claims billed versus health plan payments.

This Role Offers :

  • Medical, Dental, and Vision benefits
  • Flexible, paid vacation policy
  • Work in a flat organizational structure with direct access to leadership.

Focus :

  • Review UB-04 / IB forms for coding / billing violations.
  • Audit revenue codes against clinical documentation.
  • Confirm services billed were rendered.
  • Document inconsistencies in claims versus health plan payments.
  • Validate automatic audit results based on national and payer-specific guidelines.
  • Skill Set :

  • Facility inpatient coding / auditing experience is required.
  • Extensive experience in medical billing, coding, or auditing of insurance claims and medical records.
  • Familiarity with national coding guidelines such as CPT codes, ICD-9 / 10, HCPCS codes, DRGs, APCs, etc.
  • Knowledge of hospital-based billing / coding and PHI / HIPAA compliance
  • At least three years of experience in auditing and reviewing medical bills.
  • One of the following certifications is mandatory : CPC / COC / CIC / CRC / CPMA
  • Clinical license preferred (RN)
  • Experience working at an insurance company is preferred.
  • 100% remote work considered for the right candidate
  • Create a job alert for this search

    Bill Review Specialist • Rochester, MN

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