Repricing Associate – Temporary

This is a fully remote position, open to applicants in United States.

📋 Description

• Conduct data entry for billing information and Medicare reporting while validating ICD-10 and CPT-4 codes

• Investigate, address, and monitor inquiries to ensure adherence to state regulations

• Manage Electronic Data Interchange (EDI) claim denials and implement manual repricing as necessary

• Process and oversee reconsiderations and appeals while collaborating with vendors and provider networks

• Investigate issues related to provider returned checks and reimbursement inquiries, processing associated requests

• Engage in quarterly oversight calls/meetings with PPO Network and vendors

• Cross-train on all provider network responsibilities within the department

• Execute additional tasks as assigned

• Report directly to the Workers’ Compensation Claims Manager

⛳️ Requirements

• Comprehensive knowledge of billing and coding processes along with a strong grasp of medical terminology

• Capability to adhere to turnaround time standards and state law requirements, implementing them in the Medical Bill Repricing process

• Proficient in preparing detailed reports with minimal supervision

• Competent in remote work and possess strong computer skills

• Exceptional verbal and written communication skills, with a keen attention to detail and ability to multitask

• Ability to navigate various systems and screens concurrently

• Capability to work both independently and collaboratively in a virtual office setting

• Reliable internet connection

• Self-driven and adaptable

• Strong customer service abilities

• Competence in independently managing workload, prioritizing, and fulfilling assignments to meet deadlines

• Proficiency in MS Word, Excel, Outlook, Teams, Slack, Zoom, and internet applications

• Experience in a medical billing setting

• Familiarity with Medicare/CMS regulations

• A college degree or equivalent college-level education is preferred

• Coding certifications are advantageous

🏝️ Benefits

• Comprehensive health benefits

• Opportunities for professional development and training

• Flexible work hours

• Supportive work environment