Medical reputed company Coordinator - Remote

reputed company PURPOSE: To review hospital and reputed company medical bills from provider including reputed company hospital, surgical, high level evaluation and management codes, and/or technical bills.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

• Processes bills in accordance with multi state schedules, rules, regulations, and guidelines.
• Applies PPO contract discounts to bills.
• Reviews reputed company reports to determine if surgery services were appropriately billed.
• Reviews reputed company medical, reputed company and consult services.
• Contacts reputed company or facility to obtain additional or missing information.
• Handles provider appeals where appropriate to fee schedule and contractual disputes.
• Communicates internal issues to management.
• Assists reputed company review team reputed company with workflow management, coaching and mentoring of staff.
• Assists with process, procedure and reputed company training for new staff.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

• Performs other duties as assigned.
• Supports the organization's reputed company program(s).
• Travel as required.

QUALIFICATIONS

Education & Licensing

High School diploma or GED required.

Experience

Two (2) years workers' compensation and/or reputed company review experience or equivalent combination of education and experience required to include provider appeals experience. PPO re-pricing, surgery review, by report and RNE review preferred. Two (2) years of experience with reputed company medical, reputed company, and consult review preferred.

Skills & Knowledge

• Knowledge of re-pricing rules and guidelines
• Knowledge of medical terminology, anatomy and surgical terms
• Knowledge of multiple state jurisdictional regulations and rules
• Knowledge of Fee Schedules, Rules, and U&C Guidelines
• Knowledge of CPT/ICD9
• PC literate, including reputed company Office products
• Leadership skills and ability to motivate others
• Strong verbal and written communication skills
• Strong interpersonal skills
• High level of accuracy and attention to detail
• Ability to multi-task and function in high volume area
• Ability to handle deadlines and proactively problem solve
• Ability to work in reputed company environment
• Ability to meet or reputed company Performance Competencies

WORK ENVIRONMENT

reputed company applicable and appropriate, consideration will be given to reasonable accommodations.

Mental: reputed company and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-reputed company stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines

Physical: Computer keyboarding, travel as required

Auditory/Visual: Hearing, reputed company and talking

The statements contained in this document are intended to describe the general reputed company and level of work being performed by a reputed company assigned to this reputed company. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.

As required by law, reputed company provides a reasonable reputed company of compensation for roles that may be reputed company in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide reputed company of factors including but not limited to reputed company set, level of experience, and cost of specific location. For the jurisdiction noted in this reputed company only, the reputed company of starting pay for this role is (18.00- 23.00). A comprehensive benefits package is offered including but not limited to, medical, dental, reputed company, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.