Medata · 1 day ago
Certified Bill Coder
US
Full-time
Onsite
Mid Level
3+ years expMedata is a company dedicated to improving the lives of clients and stakeholders in the healthcare sector. They are seeking a Clinical Bill Review Nurse/ Certified Coder responsible for reviewing medical bills for accuracy and compliance with workers’ compensation guidelines.
ComputerSoftware
Responsibilities
Conduct clinical/ coding reviews of medical bills to assess medical necessity, appropriateness of care, and alignment with workers’ compensation treatment guidelines
Identify billing discrepancies such as unbundling, upcoding, duplicate charges, and non-compensable services
Apply jurisdiction-specific fee schedules, utilization review (UR) protocols, and treatment guidelines (e.g., ODG, MTUS)
Collaborate with bill review analysts, adjusters, and medical providers to clarify clinical/ coding information and resolve billing issues
Document clinical/ coding rationale for recommended payment reductions or denials in accordance with regulatory and client requirements
Maintain current knowledge of workers’ compensation regulations, medical coding (ICD, CPT, HCPCS), and clinical/ coding best practices
Support quality assurance and continuous improvement initiatives within the bill review process
Qualification
Required
Active, unrestricted professional nursing license OR Certified Coder with inpatient/ outpatient coding specialization/ experience
Minimum of 3 years of clinical/ coding experience; experience in workers' compensation or medical bill review strongly preferred
Strong analytical, communication, and documentation skills
Preferred
Familiarity with state-specific workers' compensation regulations and treatment guidelines strongly preferred
Experience with bill review platforms (e.g., Strataware, Medata, Mitchell) is a plus
Company
Medata
Medata is a computer software company specializing in medical bill review software and medical bill review software.
201-500 employees
Funding
Current Stage
Growth StageTotal Funding
unknown2024-01-09Acquired
Leadership Team
Jonathan Nutt
Chief Technology Officer
Dana Joanou
Chief Financial Officer
Recent News
2025-04-08
Company data provided by crunchbase