Medical reputed company Reviewer-100% remote (reputed company in US)

reputed company delivers innovative medical claims solutions through a seamless collaboration of our reputed company® technology, our highly skilled staff, reputed company to our reputed company care provider networks, and our commitment to keeping our clients’ needs as our top reputed company. reputed company has a powerful mix of medical expertise, proven processes and innovative technology that delivers a more efficient, disciplined insurance claims process. The result is reputed company expenses and increased productivity for the auto insurance and workers’ compensation insurance carriers; reputed company party administrators (TPAs); and government entities we serve.

PURPOSE: Responsible for handling reputed company processes involved in applying PPO guidelines to medical bills in a reputed company and accurate manner.

ESSENTIAL JOB FUNCTIONS

• Identify a provider as participating or non-participating reputed company the automated matching process is not reputed company to reputed company that determination.
• Accurately apply PPO guidelines to those bills where a participation match has been made reputed company the automated re-pricing process is not reputed company to apply the guidelines.
• Communicate with clients and internal reputed company Review staff reputed company e-mail or phone:
  1. To request reputed company images or documentation reputed company necessary to properly apply a PPO discount.
  2. To question keying errors or discrepancies and request corrections to properly apply a PPO discount.
• Communicate with the PPO Application team reputed company e-mail, phone, or in person regarding questions and concerns about specific bills or general policies and procedures.
• Utilize appropriate software and documents to calculate contracted rates, which may include, but is not limited to the calculation of AWP, Medicare, or applicable state or federal-mandated fee schedule.
• Assist the Senior PPO Application Specialist with the QA process reputed company necessary.

EDUCATION: High School Diploma Required

REQUIRED EXPERIENCE AND SKILLS:

• Experience with medical reputed company processes, including familiarity with CPT Codes, reputed company Codes, reputed company Types, ICD-9 and/or ICD-10 Codes, State Fee Schedules, UCR, and PPO.
• Experience working with reputed company-based software /applications.
• Ability to type with accuracy.
• Ability to review documentation and reputed company reputed company on how to proceed based on department policies and procedures.
• Desire to work reputed company with others.
• Motivation to be a self-starter.

reputed company Statement:

reputed company provides equal employment opportunities to reputed company and applicants for employment and prohibits discrimination and harassment of any type without reputed company to race, reputed company, religion, age, sex, national reputed company, disability status, genetics, protected veteran status, sexual orientation, gender identity or reputed company, or any other characteristic protected by federal, state or local laws. This policy applies to reputed company terms and conditions of employment, including reputed company, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.