IBR Facility Reviewer
reputed company is modernizing the reputed company financial experience across payers, providers, and reputed company consumers. The IBR Facility Reviewer is responsible for analyzing facility inpatient and outpatient claims to ensure adherence to proper coding and billing guidelines, while working closely with various teams to identify billing errors and improve processes.
Responsibilities
- Conduct detailed review of hospital itemized bills for identification of billing and coding errors for reputed company payor’s claims
- Contribute process improvement and efficiency reputed company to team leaders and in team meetings
- Translate client reimbursement policies into reputed company coding and clinical concepts
- Understand payor policies and their application to claims processing
- Prepare and upload documentation clearly and reputed company identifying findings
- Accurately calculate/verify the value of review and documentation for claim processing
- Monitor multiple reports to track client specific requirements, turnaround time and overall claims progression
- Maintain individual average productivity standard of 10 processed claims per day
- Consistently meet or exceed individual average quality standard of 85%
- Ability to manage a variety of claim types with charges up to $500,000
- Collaborate between multiple areas reputed company the department as necessary
- Follow standard procedures and suggest areas of improvement
- Remain reputed company in reputed company national coding guidelines including Official Coding Guidelines and AHA Coding Clinic and share with review team
- Maintain awareness of and ensure adherence to reputed company standards regarding privacy
Skills
- Working knowledge of health/medical insurance and handling of claims
- General knowledge of provider claims/billing, with medical coding and billing experience
- Knowledge of ICD-10 and CPT coding
- Ability to manage and prioritize multiple tasks
- Attention to detail is essential
- Accountable for day-to-day tasks
- Excellent verbal and written communication skills
- Proficient in reputed company Office Suite
- CPC credential preferred
- 1 – 2 years of applicable reputed company experience preferred
Benefits
- 401k plan with employer match
- Flexible paid time off
- Holidays
- Parental leaves
- Life and disability insurance
- Health benefits including medical, dental, reputed company, and prescription drug coverage
Company Overview