Note: The job is a remote job and is open to candidates in USA. Enlyte is a company that combines innovative technology, clinical expertise, and human compassion to assist individuals recovering from workplace injuries or auto accidents. The Billing Operations Analyst will analyze incoming medical bills for compliance with fee schedules and usual and customary applications, while also handling provider disputes and maintaining quality standards in billing operations.
Responsibilities
- Enter and independently review professional services from client submitted medical bills in bill review system covering:
- Medical bills in Smartadvisor
- Analysis on all U & C exposures
- Analysis for 6+ assigned states having fee schedules
- Multi-state Jurisdiction
- Multi-Line Business
- Hospital billing
- Provider file maintenance
- Claim file maintenance
- Handle Re-evaluation disputes
- Independent research on usual and customary/fee schedule application and system interface
- Interface in training co-workers
- Provide Quality Review as assigned by Lead/Supervisor
- Provide feedback type training in quality assurance of work product from co-workers
- All other duties as assigned by the Lead/Supervisor
Skills
- MUST BE IN THE EASTERN OR CENTRAL TIME ZONE
- 8:00 AM to 4:30 PM Central Time or 9:00 AM to 5:30 PM Eastern Time
- Ability to consistently meet the production and quality expectations
- Complete knowledge of CPT/ICD-9/HCPCS/NDS codes
- U&C bill review experience (6-9 months)
- Fee scheduling bill review experience (9-12 months)
- Multi-jurisdictional bill review experience (6+ fee schedule states)
- H.S. Diploma or equivalent
- 10-key by touch
- Strong written and communication skills
- Knowledge of CPT/ICD-9/HCPCS/NDC codes
- Knowledge of usual and customary bill review application
- Knowledge of fee scheduling bill review application
- Multi-jurisdictional bill review experience (3+ fee schedule states)
Benefits
- Medical
- Dental
- Vision
- Health Savings Accounts / Flexible Spending Accounts
- Life and AD&D Insurance
- 401(k)
- Tuition Reimbursement
- An array of resources that encourage a lifetime of healthier living
Company Overview
Enlyte is an information service company that provides case management, clinical software, and auto-physical damage solutions. It was founded in 1946, and is headquartered in San Diego, California, USA, with a workforce of 5001-10000 employees. Its website is https://www.enlyte.com/.