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Medical Bill Review Analyst Workers Compensation

Company: Avidel
Location: Irving
Posted on: February 16, 2020

Job Description:

Avidel Medical Management Company is currently seeking a Medical Bill Review Analyst for its Workers Compensation Bill Review Team. This individual will be responsible for reviewing and repricing Workers Compensation medical bills as well as providing outstanding customer service for our clients.

Responsibilities

  • Review workers compensation medical bills for compensability and relatedness to injury. Reprice Medical Bills to Workers Compensation Fee Schedule and PPO Network. Insure accurate of review of Medical Bills.
  • Depending on experience level, interact with clients (internal and external) as necessary, answering questions or researching for answers.
  • Interact with Texas Department of Insurance (Or other states Insurance Departments) or Division of Workers Compensation on issues as necessary.
  • Interact with Bill Review Software vendor (Mitchell International) as necessary.
  • All other duties as assigned.

    Specific Functions of Role
    • Review Medical Bills, Reconsideration's, and MDFR for accuracy.
    • Make decisions on how bills are processed.
    • Research issues as necessary.

      Requirements

      Experience
      • 3+ years various levels Texas Workers Compensation Bill Review experience, preferred but not required.
      • Mitchell International software experience preferred

        Knowledge

        Must possess expert knowledge in the following:
        • State Specific Workers Compensation Rules and Regulations
        • State Specific Insurance Code
        • CPT Coding
        • ICD-9/ICD-10 Coding
        • Medical Bill Review Techniques

          Skills
          • 10 Key Data Entry
            • Medical Bill Coding
              • Medical Bill Review Rules and Regulations

                Professional Qualifications
                • High School Diploma or GED and equivalent level of experience
                • Fee Schedule Experience
                • Knowledge of Worker's Compensation Rules and Regulations

                  Benefits

                  • Competitive salary
                  • Eligible to participate in company health insurance plan after your first 30 days. Dental and vision coverage are also available in our plans after 30 days.
                  • Avidel will pay your Life Insurance premium in addition to your AD&D and Long Term Disability premiums. Additional coverage is available for you to purchase.
                  • Avidel offers a flexible, paid time-off plan.
                  • The company offers ten (10) paid holidays per year.
                  • Eligibility to participate in our 401K plan begins 90 days after your start date. After one year of employment, the company will match dollar-for-dollar your first 3% of contributions and 50% on the next 2% of contributions, for a total of a 4% match. A vesting schedule for company contributions to your 401K plan is in place and you will be fully vested after six (6) years of service. You will also be eligible for an annual discretionary profit share that is variable and paid into your 401K after one full calendar year of service.

Keywords: Avidel, Irving , Medical Bill Review Analyst Workers Compensation, Healthcare , Irving, Texas

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