Medical Itemized Bill Review Specialist

Medical Itemized Bill Review Specialist Our client is a high-growth, venture-backed startup, dedicated to revolutionizing the U.S. healthcare system. They encourage collaboration among individuals with diverse backgrounds and ideologies to drive innovation. If you're passionate about leveraging cutting-edge technologies to make a significant impact on U.S. healthcare, we invite you to join this company’s mission-driven team. As a Medical Itemized Bill Review Specialist, you will play a crucial role in automating medical claim audits. You will review claim forms, patient medical records, and audit results to train their platform. The primary responsibilities include identifying coding/billing violations, auditing revenue codes against clinical documentation, and ensuring accuracy in claims billed versus health plan payments. This Role Offers: • Medical, Dental, and Vision benefits • Flexible, paid vacation policy • Work in a flat organizational structure with direct access to leadership. Focus: • Review UB-04/IB forms for coding/billing violations. • Audit revenue codes against clinical documentation. • Confirm services billed were rendered. • Document inconsistencies in claims versus health plan payments. • Validate automatic audit results based on national and payer-specific guidelines. Skill Set: • Facility inpatient coding/auditing experience is required. • Extensive experience in medical billing, coding, or auditing of insurance claims and medical records. • Familiarity with national coding guidelines such as CPT codes, ICD-9/10, HCPCS codes, DRGs, APCs, etc. • Knowledge of hospital-based billing/coding and PHI/HIPAA compliance • At least three years of experience in auditing and reviewing medical bills. • One of the following certifications is mandatory: CPC/COC/CIC/CRC/CPMA • Clinical license preferred (RN) • Experience working at an insurance company is preferred. • 100% remote work considered for the right candidate About Blue Signal: Blue Signal is a leading executive search firm specializing in healthcare recruiting. Our healthcare recruiters have expertise in placing high-performing talent in healthcare IT, medical devices, biotechnology, pharmaceuticals, etc. Learn more at bit.ly/3G5DbWr Apply Job!