Bill Review Team Lead – Workers Compensation

This is a fully remote position, open to applicants in Arizona, +3 more states.

📋 Description

• Support the daily operations of the medical bill review department under the guidance of the BR Supervisor.

• Train, develop, and mentor BR reviewers to foster a high-performance work culture.

• Oversee daily inventory management.

• Track, manage, and allocate tasks to all bill review personnel.

• Provide regular performance feedback to bill review staff at least monthly and yearly.

• Assist bill review staff with inquiries.

• Evaluate complex medical bills and provide payment recommendations based on claim history, medical documentation, customary rates, statutory regulations, state laws, fee schedules, MPN/PPO contracts, coding standards, client directives, and company policies.

• Maintain an understanding of client workflows and protocols.

• Collaborate with management to resolve client rejection files.

• Manage the client inquiry email box.

• Engage in quality assurance from the initial receipt of bills to final payment.

• Communicate with medical providers to gather information and address bill-specific concerns.

• Respond to issues and expedite problem resolution.

• Participate in continuous training initiatives.

• Keep updated knowledge of Ahshay and Billtelligent software.

• Exhibit positive behavior and lead by example.

• Provide support and assistance across all organizational levels.

• Carry out additional duties as assigned.

⛳️ Requirements

• A High School Diploma is required.

• Minimum of 3 years of experience in complex Workers' Compensation Bill Review with a background in customer service.

• Familiarity with medical terminology, CPT codes, and DRG.

• Ability to read, analyze, and interpret technical procedures, medical reports, state regulations, and fee schedules.

• CPC (Certified Professional Coding) coursework or certification is highly advantageous.

• Experience supervising team members.

• Proven capability to manage personnel in a fast-paced environment.

• Strong written and verbal communication skills.

• Excellent interpersonal skills.

• Strong organizational skills.

• Proficiency with computers and software programs (MS Word, MS Excel, Email).

• Capability to work independently with minimal oversight.

• Ability to meet deadlines in a high-pressure, time-sensitive environment.

• Must be able to lift up to 20 lbs.

• Candidates must be able to sit for the majority of an 8-hour workday, except during lunch and breaks.

• Candidates must be able to type for the majority of an 8-hour workday, except during lunch and breaks.

• Candidates must possess manual dexterity.

• Candidates must be able to speak on the telephone intermittently throughout the day.

• Candidates must be fluent in reading and writing English.

• Candidates must ensure a safe home office environment.

• Home office must comply with HIPAA regulations.

• A DSL, fiber, or cable internet connection from home is required; 100 Mbps or better is preferred.

🏝️ Benefits

• Medical, Dental, and Vision Insurance.

• 401K plan.

• Paid Time Off.

• Paid Holidays.

• Monthly internet stipend.

• Equipment provided.