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Job Summary
The Bill Review Specialist I is responsible for the audit of individual medical bills to ensure compliance with jurisdictional guidelines, state fee structures, as well as client specific guidelines.
Minimum Qualifications
+ High school diploma/GED
+ Data entry skills
+ Ability to learn ICD-9 and CPT coding
+ Ability to use of Microsoft Windows-based software
+ 10-key capabilities
+ Ability to learn and apply basic medical terminology
+ Basic computer skills Preferred Qualifications
+ 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) Primary Responsibilities
+ Process HCFA bills
+ Process UB bills
+ 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 Collateral Responsibilities
+ Process 2111 Validation 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 Performance Expectations
+ Minimum HCFA bill processing standards:
+ 75% of production expectation by (60) days from hire
+ 100% of production expectations by (90) days from hire
+ Minimum UB bill processing standards:
+ 75% of production expectation by (60) days from hire
+ 100% of production expectations by (90) 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 97% bill accuracy rate by (90) days from hire
+ Demonstrate understanding of bill review guidelines and procedures within (90) days of hire
+ Assist in processing bills within five (5) business days of their receipt by Bunch and be accountable for assigned customer(s) results, productivity and quality
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 accommodations@xerox.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*
**Location:** *Florida-Lakeland*
**Requisition ID:** *16032264*
**Virtual/work from home?** *No*