All roles

Medical Bill Reviewer-100% remote (Anywhere in US)

Remote · USA Full-time New today

No experience needed! We offer full training for our new Medical Bill Reviewer-100% Remote! Based in Remote, this position puts you in a prime location for professional and personal growth. This position requires a strong and diverse skillset in relevant areas to drive success. The compensation for this role is a competitive salary, reflecting our commitment to attracting the best.   MEDICAL BILL REVIEWER-100% REMOTE ( Anywhere in US ) Medlogix, LLC delivers innovative medical claims solutions through a seamless collaboration of our Medlogix® technology, our highly skilled staff, access to our premier health care provider networks, and our commitment to keeping our clients needs as our top priority. Medlogix has a powerful mix of medical expertise, proven processes and... innovative technology that delivers a more efficient, disciplined insurance claims process. The result is lower expenses and increased productivity for the auto insurance and workers compensation insurance carriers; third party administrators (TPAs); and government entities we serve. PURPOSE: Responsible for handling manual processes involved in applying PPO guidelines to medical bills in a timely and accurate manner. ESSENTIAL JOB FUNCTIONS  Identify a provider as participating or non-participating when the automated matching process is not able to make that determination.  Accurately apply PPO guidelines to those bills where a participation match has been made when the automated re-pricing process is not able to apply the guidelines.  Communicate with clients and internal Bill Review staff via e-mail or phone:  To request bill images or documentation when necessary to properly apply a PPO discount.  To question keying errors or discrepancies and request corrections to properly apply a PPO discount.  Communicate with the PPO Application team via 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 when necessary. EDUCATION: High School Diploma Required REQUIRED EXPERIENCE AND SKILLS:  Experience with medical bill processes, including familiarity with CPT Codes, Revenue Codes, Bill Types, ICD-9 and/or ICD-10 Codes, State Fee Schedules, UCR, and PPO.  Experience working with Windows-based software /applications.  Ability to type with accuracy.  Ability to review documentation and make decisions on how to proceed based on department policies and procedures.  Desire to work well with others.  Motivation to be a self-starter. EEOC Statement: Medlogix provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training Apply Job!  Simple Application Process Ready to join us? The first step is easy. Click apply now and we'll be in touch soon! Apply To This Job Apply tot his job Apply To this Job

Related roles

Software Development Engineer, Amazon Anywhere

Remote · USA Full-time

Remote Data Entry Clerk – Entry‑Level Data Management Specialist (Work‑From‑Home) at arenaflex – Launch Your Tech Career from Anywhere

Remote · USA Full-time

Redator Júnior

Remote · USA Full-time

Veterinary Assistant

Remote · USA Full-time

Director Core Systems Strategies – QNXT/NetworX

Remote · USA Full-time

AI Engineer (Latam, Remote)

Remote · USA Full-time

Fusion Sr. Sales Specialist, Territory

Remote · USA Full-time

People (HR) Consultant – 6 month fixed term contract

Remote · USA Full-time

Technical Product Manager

Remote · USA Full-time

Marketing Assistant

Remote · USA Full-time

[Remote] Cyber Security Analyst I

Remote · USA Full-time

Remote Data Entry Specialist – Work From Home Opportunity with arenaflex (No Prior Experience Required, Comprehensive Training Provided)

Remote · USA Full-time

Master Data Analyst – ERP & CRM Systems

Remote · USA Full-time

Director Account Services

Remote · USA Full-time

Remote Data Entry Clerk - Work from Home with Walmart - Flexible Hours & Career Growth Opportunities

Remote · USA Full-time

Field Application Specialist - Upstream and Cell Culture

Remote · USA Full-time

Tax Manager / International Tax Team

Remote · USA Full-time

Service Desk Technician (Level I / Level II)

Remote · USA Full-time

Immediate Hiring: Require Board Certified Behavior Analyst

Remote · USA Full-time

Director of Logistics Procurement, NA

Remote · USA Full-time