AvonRisk · 2 days ago
Bill Reviewer III
Orange, CA
Full-time
Hybrid
Mid Level
$25/hr - $30/hr
3+ years expAvonRisk is a company specializing in medical billing and workers' compensation. They are seeking a Bill Reviewer III to process and audit medical bills with speed and accuracy while maintaining production standards.
CommercialRisk ManagementService Industry
Responsibilities
Codes medical bills into the company system with speed and accuracy, maintaining company production standards related to quantity and quality of output
Performs preliminary screening for appropriateness and medical necessity of services rendered
Uses CPT and ICD9/ICD10 codes, fee schedules, and other resource materials to determine appropriate reimbursement of billed services, including applicable fee schedule and/or repricing rational
Flags any problem bills to the BR supervisor
Communicates with clients and/or providers to clarify information
Forwards to Bill Review supervisor any unidentifiable unlisted procedure numbers
Ability to price hospital and surgery bills to applicable fee schedules
Ability to process reconsideration requests as assigned
May specialize in state specific or client specific areas of responsibility
Assists with bill review reporting functions (internal and external reports)
May specialize in state specific or client specific areas of responsibility
May assist is answering provider calls
May travel to other offices to assist with training
Qualification
Required
High school diploma or general education degree (GED)
Minimum of one year data entry/medical billing experience
Additional two years bill review experience in a workers' comp environment
Strong knowledge of CPT and ICD9/ICD10 coding and workers compensation fee schedules
Familiar with workers' compensation regulations
Good comprehension of company software system process
Must have Medical Bill Reviewer Designation – 40 hour initial certification plus continuing education hours of 16 hours every 2 years
Company
AvonRisk
AvonRisk is a provider of risk management, claims administration, and managed care services for carriers, employers, and public entities.
501-1000 employees
Funding
Current Stage
Late StageCompany data provided by crunchbase