Medical Billing and Coding Reviewer

Job Description The Reny Company's bill reviewer is a professional who combines experience in health insurance and medical billing with business insight and a passion for great service. Purpose of this role is to support Claims by analyzing medical, hospital, durable medical equipment, pharmacy, home health, etc. bills and records/reports to determine billing accuracy and appropriateness. This support is achieved by utilizing intelligent software and by understanding and applying knowledge of medical code billing and claims processing rules and regulations, billing practices, code sets, and state and Medicare adjustment reimbursement principles, knowledge of WC fee schedules. Support is also achieved by providing education and training regarding provider billing and documentation, identifying and bringing to management's attention any unusual or emerging procedures or billing anomalies. The bill reviewer will ensure the highest level of accuracy of data entry into our bill review system for claims processing.

PLEASE DO NOT APPLY IF YOU DON'T HAVE THE EDUCATION AND MEDICAL BILL REVIEW EXPERIENCE

Two or more years of experience in a medical bill review analyst position preferred. Medical coding knowledge needed. Prior experience in a payer environment working with claims systems and bill review software is a plus.

Based upon situation or state specific issues meet 98% accuracy, 10,000+ keystrokes per hour

Process medical bills for workers' compensation, Texas non subscription, maritime, occupational accident, and liability claims

• Data entry into system applying usual and customary, worker's compensation and liability ground rules and fee schedules
• Continuous enhancement of working knowledge of medical forms such as CMS-1500, UB-92, UBO4/DWC-9/DWC-10
• Increase knowledge of coding principles CPT, ICD-9 / ICD-10, DRG, Revenue codes
• Associates degree or equivalent work experience Certified Professional Coder certification such as CCA. Experience with Medical Bill Review preferred
• High school diploma or equivalent, college preferred
• Two to three years of medical claims experience
• Knowledgeable of Excel, Word, Outlook, etc.
• Except where required or permitted by law, employment practices will not be influenced or affected by an applicant's or employee's race, color, religion, sex, national origin, ancestry, citizenship, age, handicap or disability, marital status, medical condition or any other characteristic protected by applicable law.

ONLY THOSE WITH RELEVANT EDUCATION AND MEDICAL BILL REVIEW EXPERIENCE NEED APPLY

Company Description The Reny Company is a rapidly growing health care cost containment company, helping clients save money and better navigate our changing health care system. We specialize in medical bill review and negotiation services for workers compensation, non-subscribers, third party administrators, and maritime clients.

The Reny Company is a rapidly growing health care cost containment company, helping clients save money and better navigate our changing health care system. We specialize in medical bill review and negotiation services for workers compensation, non-subscribers, third party administrators, and maritime clients.