Job Description

Job Description

Our Ideal Candidate

As a Bill Review Specialist, you are responsible for applying WellRithms’ reimbursement methodology through medical bill review. This role requires expertise in medical billing and CPT coding, as well as the ability to process medical bills accurately and efficiently. Experience in group health or workers’ compensation is a strong plus. You’ll have the opportunity to develop a deep understanding of our clients’ workflows, protocols, and operational needs across all types of medical bills. This role reports to the Bill Review Supervisor.

Responsibilities

• Analyze medical bills and ensure the WellRithms reimbursement methodology is applied effectively.
• Perform a thorough review of the medical bill, records, and itemized charges to determine a reasonable reimbursement amount.
• Review, process, and validate the correct use of medical billing CPT codes.
• Correct 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 HCFA1500 and UB-04 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.

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