Bill Review Analyst - Woodland Hills

Under regular supervision the Analyst will be responsible for processing medical bills and evaluate technical information for consistency and accuracy, applying established guidelines of Bill Review protocols in accordance with prevailing Fee Schedules and and/or UCR guidelines.








Accurately audit and re-code as needed, medical bills at the rate of 120 bills per day with a 98% accuracy rate.


Identify and handle problem billings, and independently research appropriate reimbursement of billed services.


Identify repetitive errors and questionable system errors. Report information to immediate supervisor to improve overall quality and consistency of team/department work product.


Performs other duties and projects as assigned.


High school diploma, some college preferred.


Proficiency as a Bill Validation Auditor or previous experience in medical bill review or insurance industry.


Familiarity of CPT & ICD-9 codes and thorough understanding of medical terminology.


Intermediate proficiency in MS Office, exceptional10-key (10,000 ksph) and 45 wpm typing skills.


3 out of the last 5 years experience processing California Workers' Comp as well as knowledge of CA schedules and guidelines


Good oral and written communication skills.


 







REF: CAAR162873

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