The RequirementsTo be a strong fit for the Bill Review Analyst opportunity, you will have:
- A high school diploma or GED equivalent; some college preferred
- 2+ years of experience in a medical billing, workers comp claims, claims adjuster or similar role
- Knowledge of industry coding (revenue codes, ICD classifications, CPT codes, etc.)
- Working knowledge of healthcare industry terms such as HL7, PHI, HIPAA, HITECH, etc.
- Experience working with claims data and analysis, especially in cost and utilization analysis
- Experience analyzing commercial, Medicare and/or Medicaid medical, dental and/or behavioral health claims
- Ability to process a daily quota of bills as assigned by the Team Lead and/or Production Manager
- Ability to keep up with production and maintain a high degree of accuracy
- Strong computer skills, including MS Office Suite (e.g. Word, Excel, Outlook)
- Strong writing, spelling and grammar skills
- Strong verbal and written communication skills to effectively communicate with team members, clients, and providers in person, over the phone and via email
- Strong data analysis skills and good decision-making ability
- Excellent follow-through skills
- Strong organization, prioritization and time management skills; ability to balance multiple priorities
- Ability to work independently, with little direction, and as a reliable team member
- Self-motivation with the ability to keep up with production requirements
- Flexibility and adaptability; the disposition to thrive in a growing, changing environment
- The drive, desire and ability to learn quickly and retain information
To be considered for the role, you must be authorized to work in the US without sponsorship or restriction. Qualified candidates must be able to pass a background check.
The RoleOpportunity Snapshot
Reporting to the Production Manager and working closely with the Team Lead, as Bill Review Analyst, you will be responsible for reviewing and reducing medical bills per the appropriate State Workers’ Compensation claims guidelines.
We expect that you will have some good experience coming in the door, and we will build on that experience with a strong training program. You will sit with our trainer -- the Team Lead -- learning our systems, processes and expectations. While you will eventually work up to daily production goals, you will first take the time to get very comfortable in your knowledge and duties. For example, once you go through initial training, you'll work on your own but have your work reviewed before release. Once your work is consistently correct and accurate and any gaps have been addressed, you will begin working independently and meeting volume, accuracy and timing goals.
You will join a growing and talented team of ten. You may be assigned specific accounts with billing across multiple states (you'll learn the unique requirements of each) for which you'll be responsible. We are a collaborative group but also manage our individual responsibilities independently.
Bills are scanned into our system and it will be your responsibility to review your clients' bills throughout the day. You will strive for an average completion rate of 120 per day with 97% accuracy. You will:
- Review the data, ensuring it has been entered correctly and that there is no missing information.
- Perform auditing functions such as determining why a bill was stopped; what needs to be done; if the correct fee schedule was used, etc.
- Make corrections as needed.
- Developing EOBs (explanation of benefits) for clients’ review of charges and necessary treatment.
- Meeting performance and turnaround time guidelines for each client.
- Answering emails and calls from clients, providers and staff regarding assigned accounts.
- Remaining current on changes that occur with CPT, ICD and revenue codes as pertaining to assigned accounts.
More Good ReasonsBuild a career home
Growth equals opportunity and we anticipate additional opportunities for our proven performers. You could advance in this role, perhaps stepping up to a lead position, or pursue other paths within our organization. Some opportunities would require relocation. If you're ready to build your career within the recession resistant healthcare industry, with a company that will support you over the long haul, this role could be your perfect fit.
In addition to a competitive wage, you will enjoy a comprehensive benefits package including medical, dental, vision, prescription drug and life insurance options; a 401(k) plan with company match; paid vacation, sick time and holidays; flexible spending accounts; tuition assistance; and more.
Strong, growing company
Founded in 2004 through the merger of two medical cost management companies, Equian has grown to become one of the nation's leading companies for healthcare reimbursement analysis and payment integrity. We have been voted one of 40 "Healthcare's Hottest" by Modern Healthcare and have been recognized by Inc. 5000 as one of the fastest growing companies in the United States. We are continuing our growth through acquisition, and intend to keep growing for years to come.
Equian offers a distinctive and rewarding work experience for associates at all phases of their careers -- from workforce newcomers to seasoned professionals. As an industry leader, we seek to attract, develop and retain associates sharing our commitment to innovation, continuous improvement, superior service and professional curiosity.
Keys to SuccessNaturally, your technical skills will be critical, but your interpersonal communication skills, positive attitude, problem-solving ability and work ethic will have an equal impact on your success. Those who thrive and excel here are:
- Thinkers -- they don't blindly walk through the steps of their role, but think critically about problems and find solutions.
- Learners -- they are dedicated to advancing their skills by asking questions, learning and growing from mistakes and staying up to date with the knowledge they need to optimally perform their roles.
- Doers -- they take a proactive approach to their work.
- Dedicated -- they can be counted on to work their shifts, support their teammates, and meet their responsibilities.
- Accurate & timely -- they take pride in their work and doing a good job.
About UsEquian is a leading provider of technology-enabled, data-driven solutions ensuring payment integrity across the healthcare, workers compensation and property & casualty industries.
One of our nation's most pressing challenges is the rising cost and affordability of healthcare. At Equian, our efforts are dedicated to addressing this challenge. We provide solutions that ensure each healthcare interaction is paid accurately and at the lowest possible cost. We have a proven system to reduce healthcare cost through proprietary data analytics coupled with deep domain expertise. Once we have aligned with you and analyzed all of the data, we provide integrated payment integrity solutions that eliminate unnecessary spending.
With more than 1400 talented professionals working across the country, our people have transformed Equian into the thriving organization it has become today. Our team includes market experts for each industry we serve, so you can be sure we are ready to hit the ground running for you. Equian's team is dedicated to building lasting partnerships with clients. It is simply what we do best
Equian is backed by New Mountain Capital, a leading healthcare investment firm, and is recognized nationally by Inc. Magazine and Modern Healthcare as a leading high-growth company in health care.
Video: Equian team members share their thoughts around why the company is enjoying ongoing strong growth.