Workers? Compensation Medical Bill Reviewer
The position is responsible for the medical review of health care provider billing in accordance with the Texas Workers' Compensation Act . <?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" /> SKILLS AND ABILITIES: · Ability to effectively communicate orally and in writing · Input, access, and retrieve data from computer software system · Ten-key by touch; a minimum of 7,000 key strokes per hour · Ability to learn technical material · Ability to identify HCFA 1500 and UB-04 medical forms RESPONSIBILITIES INCLUDE : · Review, evaluate, and investigate medical bills for compensability of medical services in compliance with the Texas Workers? Compensation Act and departmental procedures with direct guidance. · Review medical reports/documentation for usual and customary treatment, unbundling of procedures, correct coding of services performed and causal relatedness. · Identify abusive billing practices and treatment that falls out of the usual/customary norms based on diagnosis. · Assist in answering telephone inquiries from providers, adjusters, and injured employees · Input required data from health care provider bills into the software system as needed KNOWLEDGE AND EXPERIENCE: · Basic understanding of insurance industry · Knowledge of CPT, ICD and HCPC coding · Familiar with medical terminology and procedures · High school graduate or equivalent · Knowledge of workers? compensation acts and rules preferred but not required · At least one year of clerical/data entry experience For immediate consideration please submit your resume. Job Experience: 1-3 Years About Ajilon Professional Staffing Ajilon Professional Staffing is a leader in temporary and permanent recruitment services with offices across North America. We offer clients and job seekers niche industry expertise and job market insight in professional disciplines including corporate management, human resources, non-clinical healthcare and office support. Keywords: Accounting
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