Workers’ Compensation Medical Bill Reviewer

Insurance Placement Solutions (IPS) has an immediate opening for a Workers’ Compensation Medical Bill Reviewer with our client in Rocklin, California. This is a temporary opportunity providing coverage for an employee leave of absence.

In this role, you’ll review, audit, and process workers’ compensation medical bills in accordance with applicable fee schedules and reimbursement guidelines. You’ll use CPT and ICD coding, workers’ compensation fee schedules, and other billing resources to determine appropriate reimbursement while meeting established accuracy and production standards.

Workers’ Compensation Medical Bill Reviewer Responsibilities

• Review and process workers’ compensation medical bills accurately and efficiently
• Apply applicable workers’ compensation fee schedules to determine appropriate reimbursement
• Use CPT and ICD-9/ICD-10 codes to review and price medical services
• Perform preliminary reviews for appropriateness and medical necessity of billed services
• Price hospital and surgical bills according to applicable fee schedules
• Review billing documentation and identify discrepancies or issues requiring additional review
• Process reconsideration requests as assigned
• Communicate with medical providers and clients to obtain or clarify billing information
• Escalate unidentified procedures, complex bills, and other issues to the Bill Review Supervisor
• Assist with provider inquiries as needed
• Maintain established production and quality standards
• Handle state-specific or client-specific bill review assignments as needed

Qualifications

• Minimum of 1 year of data entry or medical billing experience
• Minimum of 2 years of medical bill review experience within a workers’ compensation environment
• Experience reviewing and applying workers’ compensation medical fee schedules
• Strong knowledge of CPT and ICD-9/ICD-10 coding
• Experience reviewing hospital and surgical medical bills
• High school diploma or GED

Technical Skills

• Experience with medical billing or bill review software
• Proficiency with word processing, spreadsheet, and database applications

Licensing & Certifications

• Medical Bill Reviewer Designation required
• 40-hour initial Medical Bill Reviewer certification required
• 16 hours of continuing education required every two years

Work Arrangement

• Temporary assignment
• Position based in Rocklin, California

About Insurance Placement Solutions

Insurance Placement Solutions is a staffing and recruiting firm specializing in the insurance industry. We connect talented professionals with temporary, temp-to-hire, and direct-hire opportunities at leading insurance organizations across the United States.

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