Medical BillProcessAuditor I

Under moderate supervision, this position is responsible for analyzing incoming medical bills for fee schedule or usual and customary application as well as PPO interface while meeting contractual client requirements.

Requirements/Skills/Qualifications:

• Proficiency as a Bill Review Analyst with two or more years previous experience in medical bill review (workers` compensation is a plus)

• Bachelors Degree in Nursing or other health-related courses or Certification in Coding

• Strong knowledge of Medical Terminology and CPT / ICD-9 / ICD-10 coding Knowledge of multli-state fee schedules preferred.

• Ability to work in a high production environment while rmeeting productivity and quality standards.

Duties:

• Enter and review workers compensation or no-fault medical bilis into the Medata systemn.

• Analyse and review of 1 or more assigned states having fee schedules.

• Select proper PPO network based on client instructions.

• Add or update Provider and Claim information as appropriate