Committed and motivated Billing Specialist with exceptional customer service and decision making skills. Strong work ethic, professional demeanor and great initiative.
•Responsible for making bill review processing determination according to rules and regulations and or third party partner.
•Evaluates medical bills and corresponding EOR's for accuracy and compliance with state mandated fee schedule(s) and our business rules and guidelines.
•Reviews inpatient hospital, outpatient hospital and multiple surgery billings
.•Refers to reference library of fee schedules, CPT, ICD-9 (10), HCPCS and other industry publications to support findings.
•Apply contracted rates for specialty network and pricing bills.
•Identifies system and/or bill review processing issues and reports findings to Supervisor or Manager.
•Demonstrates a dependable work ethic.
•Manages confidential client information with discretion and good judgment in accordance with department and company guidelines.
•Collaborates with supervisor to develop skills and knowledge.
•Responds to written or verbal provider inquiries relating to our bill review analysis. Analyzes problems using problem solving methodology skills to determine root cause; communicates and implements solutions.
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