State Licensed Complex Bill Reviewer

Job Summary

A company is looking for a Complex Bill Reviewer 2.

Key Responsibilities

• Conduct medical reviews of provider and hospital bills for coding and billing accuracy
• Audit complex medical bills and insurance claims for compliance with company policies
• Process claims in a timely manner while identifying opportunities for cost management

Required Qualifications

• Active RN, LPN, or LVN license in good standing
• 3-5 years of clinical experience, particularly in specialized areas
• Proficiency in medical coding (CPT, HCPCS, ICD-10) and billing guidelines
• Previous experience in medical claim review and workers compensation preferred
• Experience with electronic medical records and bill review platforms preferred