Provider Relations Specialist - Workers Comp - REMOTE!
EK Health Services
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- Pay
- $19 to $21
- an hour
- Location
- Sparks, NV
- Work style
- Remote only
- Job type
- Full time
- Posted
- Oct 26
- 2 days ago
Career path
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About the company
EK Health Services
Hospital & health care · 201 to 500 employees
What you'll do
- Analyze medical bills based on claim jurisdiction, medical notes, rates, regulations and guidelines
- Receive provider calls, emails and voicemails and respond within 48 hours
- Monitor bills from initial receipt through final payment
- Review medical billing codes and report improper use
- Work with the Bill Review team on quality assurance issues
- Communicate with providers to obtain information to resolve bill-specific issues
- Respond to clients, adjusters and providers' questions quickly and professionally
What you need
- High School Diploma
- 2+ years of experience in complex Workers' Compensation Bill Review with customer service exposure
- Knowledge of medical terminology, CPT codes, and DRG
- High comfort level with computers and computer programs (MS Word, MS Excel, Email)
- Ability to read, analyze, and interpret technical procedures, medical reports, state laws and fee schedules
- Strong Written and Oral Communication & Interpersonal Skills
- Able to sit and keyboard the majority of an 8-hour day, with manual dexterity
- CPC (Certified Professional Coding) coursework or certification (preferred)
- Education: a high school diploma or a professional certificate
Key skills
Workers' Compensation Bill Reviewmedical terminologyCPT codesDRGMS WordMS ExcelInterpersonal SkillsCPC coursework or certification
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Perks
- Medical
- Dental
- Vision Insurance
- 401K
- Paid Time Off
- Paid Holidays
- Monthly internet stipend
- Equipment provided
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Job Type
Full-time
Description
Please note:
At this time, we are not accepting or considering applicants residing in
California (CA), New York (NY), or
Hawaii (HI).
Under the direction of the Bill Review Team Lead, the
Provider Relations Specialist
is responsible for assisting in a full range of provider relations and service interactions with the provider community, EK Health clients and partners. This position establishes and fosters relationships and works directly with the Bill Review team to resolve all requests related to bill processing.
Position Specifics:
Full-time, Non-Exempt position; working Monday through Friday 8-hour work day -
8am-4:30pm PST
(Remote)
The job responsibilities will include, but are not limited to:
Accurately and appropriately analyze all types of medical bills based on claim jurisdiction, medical notes, usual and customary rates (UCR), statutory regulations including state laws and fee schedules, available MPN/PPO contracts, coding guidelines, client instructions, and company policies and procedures
Must be able to understand how a bill was processed and communicate to providers the methodology for processing and re-pricing the bill
Receive all provider calls, emails and voicemails and respond within 48 hours
Monitor the bill review process from initial receipt of bills through final payment
Reviews and verifies the correct use of medical billing codes and reports the detection of improper use of billing codes to Client Inquiries, Enforcer or QA team
Work with the Bill Review team on all quality assurance issues identified for review and handling
Communicate with medical providers to obtain needed information to resolve bill-specific issues
Communicate directly with clients, adjusters and providers offering excellent customer service by responding to and answering their questions quickly and professionally
Participate in ongoing training to enhance job skills and knowledge
Other duties as assigned
Pay & Perks
Pay $19-21/hr based on experience, education and location
Medical, Dental and Vision Insurance
401K
Paid Time Off
Paid Holidays
Monthly internet stipend
Equipment provided
Requirements
High School Diploma required
2+ years of experience in complex Workers' Compensation Bill Review with customer service exposure.
Knowledge of medical terminology, CPT codes, and DRG.
High comfort level with computers and computer programs (MS Word, MS Excel, Email)
Ability to read, analyze, and interpret technical procedures, medical reports, state laws and fee schedules.
Hospital Bill Review experience a plus.
CPC (Certified Professional Coding) coursework or certification a big plus.
Strong Written and Oral Communication & Interpersonal Skills
Physical Requirements:
Candidate must be able to sit the majority of an 8-hour day except for lunch and break times. Candidate must be able to keyboard the majority of an 8-hour day except for lunch and break times. Candidate must have manual dexterity. Candidate must be able to speak on the telephone intermittently throughout the day. Candidate must be able to read and write English fluently. Candidate must be able to provide and confirm safe home office environment. Home office must be HIPAA compliant.
*Requires DSL, fiber, or cable internet connection from home 100 Mbps preferred or better. *