Nexmc

Description The remote Coder/Specialty Medical Bill Reviewer is responsible for reviewing, auditing, and data entry of medical bills for multiple states and lines of business within both Worker’s Compensation and Commercial Health arenas. This would include analysis for the fee schedule or usual and customary application, as well as PPO interface, while meeting contractual client requirements. Essential Job Functions: Responsible for auditing medical bills to ensure that they are appropriate and adhere to the State Fee Schedules, customer guidelines, and PPO discounts Analysis and review of 1 or more assigned states having fee schedules Utilize Fee Schedules, Online Documents, Client instructions, and other training material to properly review medical bills Review medical bills for compensability and relatedness to injury Reprice medical bills to Workers’ Compensation Fee Schedule and PPO Network Research usual and customary/fee schedule applications and system interface as...

A leading medical billing service provider is seeking a remote Coder/Specialty Medical Bill Reviewer responsible for auditing and reviewing medical bills across various states. The candidate should possess AAPC Coding Certification (CPC required, CIC preferred) and have a solid understanding of medical terminologies and billing guidelines. Responsibilities include ensuring compliance with state fee schedules, analyzing medical bills for accuracy, and communicating findings with clients. Join a dynamic team committed to delivering quality in a fast-paced environment. #J-18808-Ljbffr