Medical Bill Processor (work from home)

Website Sedgewick



IF YOU CARE, THERE’S A PLACE FOR YOU HERE

For a career path that is both challenging and rewarding, join Sedgwick’s talented team of 27,000 colleagues around the globe. Sedgwick is a leading provider of technology-enabled risk, benefits and integrated business solutions. Taking care of people is at the heart of everything we do. Millions of people and organizations count on Sedgwick each year to take care of their needs when they face a major life event or something unexpected happens. Whether they have a workplace injury, suffer property or financial loss or damage from a natural or manmade disaster, are involved in an auto or other type of accident, or need time away from work for the birth of a child or another medical situation, we are here to provide compassionate care and expert guidance. Our clients depend on our talented colleagues to take care of their most valuable assets—their employees, their customers and their property. At Sedgwick, caring counts®. Join our team of creative and caring people of all backgrounds, and help us make a difference in the lives of others

Sedgwick’s bill review services are part of a customized solution for clients that ensures medical bills are paid timely and at the appropriate cost. Our utilization review (UR) nurses and bill reviewers look for all possible savings and use the most accurate re-pricing system available to make sure bills are paid appropriately based on state rules and regulations, UR treatment plans, clinical edits and other applicable reductions.

PRIMARY PURPOSE: To code provider bills; to enter pre-coded billing data into the system; and to verify the output.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

  • Keys pre-coded billing data into the system.
  • Identifies and forwards complex bills to claims examiners.
  • Codes provider bills in accordance with claims management system notes and state guidelines.
  • Follows workers compensation/auto guidelines to evaluate the services.
  • Compares qualifications of service provider with service provided.
  • Involved in system maintenance/file maintenance and interface with IT department.
  • Assists in account batching and distribution of incoming and outgoing mail.
  • Answers customer service calls from providers, clients and claims examiners.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

  • Performs other duties as assigned.
  • Supports the organization's quality program(s).

QUALIFICATIONS

Education & Licensing

High School diploma or GED required.

Experience

One (1) year of general office experience or equivalent combination of education and experience required. Knowledge of medical terminology preferred.

Skills & Knowledge

  • Excellent oral and written communication
  • PC literate, including Microsoft Office products
  • Analytical and interpretive skills
  • Strong organizational skills
  • Good interpersonal skills
  • Ability to work in a team environment
  • Ability to meet or exceed Performance Competencies

WORK ENVIRONMENT

When applicable and appropriate, consideration will be given to reasonable accommodations.

Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines

Physical: Computer keyboarding, travel as required

Auditory/Visual: Hearing, vision and talking

The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

To apply for this job please visit sedgwick.wd1.myworkdayjobs.com.

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