Xerox Bill Review Specialist I in Irvine, California
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Position: Bill Review Specialist
Department: Medical Bill Review
Reports to: Supervisor
Location: Irvine, CA, Lakeland, FL, or Work-From-Home
FLSA status: Non-Exempt
The Bill Review Specialists is responsible for the audit of individual medical bills to ensure compliance with jurisdictional guidelines, state fee structures, as well as client specific guidelines.
High school diploma/GED
data entry skills
ability to learn ICD-9 and CPT coding
ability to use of Microsoft Windows-based software
ability to learn and apply basic medical terminology
basic computer skills
One (1) or more years of experience in Medical Bill Review
One (1) or more years of experience in Workers’ Compensation
certificate of completion of medical coding and medical terminology program (technical center)
Process HCFA, processional, facility, pharmacy, non-confirming bills to state guidelines
Compares data entered with source documents, or re-enters data in verification format on screen to detect errors.
Demonstrated mastery of processing rules
Demonstrated understanding of bill review guidelines and procedures
Accountability for assigned customer(s) results, productivity and quality
Ensure authorization action is applied appropriately
Compare qualifications of service provider with service rendered
Maintains reference library of company and industry reimbursement policies.
Process all bills in a timely manner to meet client expectations
May require one (1) year of demonstrated knowledge, skills and abilities in Validation and/or Link & Authorization as appropriate for assignment
Demonstrate ability to manage time effectively and efficiently
Responsibility for continuous learning and development of skills necessary to fully contribute to the organization
Demonstrate the ability to work individually, as well as collectively, to address business challenges
Minimum bill processing standards:
75% of production expectation by (60) days from hire
Minimum processing rules mastery:
Complete California certification, as required by Management
Competency of (1) fee schedule jurisdiction within (30) days from hire
Competency of fee schedule guidelines for all assigned states within (90) days from hire
Maintain a monthly average of 98% bill accuracy rate by (90) days from hire
Demonstrate understanding of bill review guidelines and procedures within (90) days of hire
Physical Demands and Work Environment
The physical demands and work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Physical demands : prolonged sitting; use hands to finger or handle objects or controls; occasionally reach with hands and arms; occasionally lift and/or move up to 5 pounds; talk; hear; prolonged viewing of computer monitor.
Work environment : indoor office environment; minimal noise level.
Xerox is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, creed, religion, ancestry, national origin, age, gender identity, sex, marital status, sexual orientation, physical or mental disability, use of a guide dog or service animal, military/veteran status, citizenship status, basis of genetic information, or any other group protected by law. People with disabilities who need a reasonable accommodation to apply or compete for employment with Xerox may request such accommodation(s) by sending an e-mail to email@example.com. Be sure to include your name, the job you are interested in, and the accommodation you are seeking.
Job: Service Delivery Healthcare
Organization: Workmans Comp Site
Title: Bill Review Specialist I
Requisition ID: 16027648
Virtual/work from home? No