Bill Review Specialist

Job Summary The Bill Review Specialist connects our clinical data with strategy. In this role, you will apply specialized expertise in medical data entry, and national repricing systems to analyze complex, high-exposure medical claims and litigation demands. By conducting precise line-item audits, you uncover billing irregularities and deliver clear, defensible insights that attorneys and adjusters rely on to make fair, evidence-based decisions. Your work directly safeguards reimbursement integrity and upholds Dane Street’s reputation for excellence in the legal and healthcare communities. Mission, Culture and Values At Dane Street, we believe exceptional employee experiences create exceptional client experiences. Our culture is built on collaboration, continuous improvement, accountability, and care. We care for our customers, we care for our employees, and we care for one another. Every team member plays an important role in creating an environment where people feel respected, supported, empowered to grow, and inspired to do meaningful work. What You'll Do Conduct regular quality control of reports Software & Payer System Repricing Optimization Apply knowledge of repricing payer guidelines to maximize accuracy and identify erroneous billing/overbilling. Ensure correct application of fee schedules, line-item audits,CCI edits, and clinical validation rules across commercial, auto/PIP, and workers' compensation lines. Translating complex coding systems (CPT, ICD-10, HCPCS, DRG) into plain language for attorneys. What Makes this Role Successful The Bill Review Specialist role combines analytical precision with a sharp eye for clinical coding and reimbursement integrity. You thrive in the details, moving effortlessly between line-item audits and national repricing platforms to spot billing anomalies, unbundling, and fee schedule discrepancies. By consistently applying NCCI edits and clinical validation rules, you ensure every report produced is audit-proof, accurate, and aligned with current payer guidelines. You can also successfully translate dense coding structures into straightforward, plain-language insights that attorneys and adjusters can confidently stand behind during litigation and settlement negotiations. What Your First 90 Days May Look Like First 30 days Become familiar with Dane Street's Medical Bill Review processes, systems, and workflows. Learn national repricing systems, payer guidelines, and client-specific requirements. Understand fee schedules, UCR benchmarks, NCCI edits, and coding guidelines. Review sample medical bills and reports to understand quality and accuracy expectations. Become familiar with CPT, ICD-10, HCPCS, and DRG coding. First 31-60 days Independently review and audit medical bills and supporting documentation. Identify duplicate, excessive, unsupported, unbundled, or incorrectly billed charges. Apply appropriate fee schedules, repricing guidelines, and coding edits. Prepare accurate and detailed bill review reports. Meet established productivity, quality, and turnaround time expectations. Communicate billing discrepancies and findings clearly to the appropriate teams. First 61-90 days Consistently manage assigned bill review workload with accuracy and efficiency. Demonstrate proficiency in repricing systems and medical billing guidelines. Produce accurate, complete, and defensible reports. Independently identify billing irregularities and reimbursement discrepancies. Translate complex billing and coding information into clear, understandable findings. Identify opportunities to improve review accuracy, workflow efficiency, and overall quality. WORKING CONDITIONS/PHYSICAL DEMANDS Any lifting, bending, traveling, etc. required to do the job duties listed above. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this role. Examples: Prolonged periods of sitting or remaining stationary at a desk and working on a computer. Constant operation of a computer, keyboard, mouse, and other digital productivity tools. Close visual acuity required to view computer screens, analyze data, and read extensive digital documentation. Frequent communication with team members, leadership, and external partners via email, chat, phone, and video conferencing platforms. Occasional moving or positioning of office equipment or files weighing up to 10–15 pounds. Why Join Dane Street? Collaborative remote culture Professional growth opportunities Meaningful work supporting the healthcare industry Comprehensive benefits Great Place to Work Certified since 2021 Commitment to employee development WORK FROM HOME TECHNICAL REQUIREMENTS Supply and support your own internet services. Maintain an uninterrupted internet connection. Equal Opportunity Statement At Dane Street, caring for people is at the heart of what we do. We are committed to creating an inclusive workplace where every employee feels respected, valued, and empowered to contribute. We provide equal employment opportunities to all applicants and employees and make employment decisions based on qualifications, merit, business needs, and without regard to race, color, religion, sexual orientation, gender identity or expression, national origin, age, disability, veteran status, or any other characteristic protected by applicable federal, state, or local law. EDUCATION/CREDENTIALS A High School Diploma or equivalent Must Haves Experience reviewing invoices, billing statements, or financial documentation. Ability to identify incorrect, duplicate, or unsupported charges. Strong attention to detail and accuracy. Ability to identify improperly bundled, unbundled, or redundant charges (if this is essential to the role). Preferred Qualifications Previous experience identifying improperly bundled, unbundled, or redundant charges. Experience in the specific industry or billing environment. Familiarity with applicable billing guidelines and regulations. Experience resolving billing discrepancies and communicating findings. .Experience in Fee schedule UCRs /Bench Mark surveys. Join our team at Dane Street and enjoy a comprehensive benefits package designed to support your well-being and peace of mind. We offer a range of benefits including medical, dental, and vision coverage for you and your family. Additionally, we offer voluntary life insurance options for you, your spouse, and your children. We also offer other voluntary benefits which include hospital indemnity, critical illness, accident indemnity, and pet insurance plans. Employees receive basic life insurance, short-term disability, and long-term disability coverage at no cost. Our generous paid time off policy ensures you have time to relax and recharge, while our 401k plan with a company match helps you plan for your future. Apple equipment and a media stipend are provided for remote workspace. #J-18808-Ljbffr Dane Street, LLC