Certified Medical Bill Repricer / Coder, Workers' Compensation

Certified Medical Biller/Coder, Workers' Compensation and Auto Injuries Certified coders only please. Experience in CPT-coding/record review for Medicare, workers’ compensation and auto insurance is highly preferred. PLEASE NOTE: This job may be performed from the coder's home; however, it is highly preferred that the coder reside in Pennsylvania or surrounding states, including Maryland and New Jersey, as the selected candidate may be required to travel to our Mechanicsburg, PA office occasionally (e.g, for training, etc.). Under direct supervision, the medical biller/coder meets daily production quotas in analyzing and processing medical invoices. Responsible for reviewing and analyzing medical bills submitted for workers' compensation and/or auto claims, ensuring accurate coding based on the provided medical documentation, and adjusting billed charges to reflect the appropriate reimbursement amount according to established/prevailing fee schedules or UCR guidelines, state regulations, PPO reductions, negotiated savings, etc., with a focus on cost containment and compliance within the workers' compensation system. Duties include:

• Efficiently repricing and directing incoming bills by analyzing bill payments based on guidelines of prevailing fee schedule
• Accurately and efficiently coding medical bills into repricing database
• Reviewing medical fee and other supporting documentation for appropriate use of CPT and ICD-10 codes/fee schedules
• May review screens, including duplication and prior authorization verification, and other resource materials to determine appropriate reimbursement of billed services
• Flag problem bills for review by supervisor.
• Certified medical bill coders and/or those with workers' compensation bill repricing preferred.

Required skills/abilities include:

• Coding certification with demonstrated billing/coding experience
• Experience repricing WC & Auto bills in New York jurisdiction a plus
• Ability to speak and write clearly and concisely, while applying strong interpersonal communication skills
• Ability to adapt to changes in duties and assignments in the work environment
• Ability to organize, prioritize and coordinate multiple tasks
• Ability to produce work in high quantity and quality
• Proficiency in Microsoft Office applications; Word, Outlook (Excel a plus) and standard office equipment, including computers, fax machines, copiers, printers, telephone, calculators, etc.

Mental/Physical Requirements

• Involves sitting and working with a keyboard and monitor for the entire workday.

Job Type: Full-time Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Application Question(s):

• Do you reside in Pennsylvania, Maryland or New Jersey?

Experience:

• Bill Review or Coding: 1 year (Required)

License/Certification:

• Medical Bill Review/Coding Certification (e.g., AAPC, CPC) (Required)

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