Posted: Wednesday, May 10, 2017 4:04 AM
Mitchell International, Inc. is a leading provider of information and workflow solutions to the Property and Casualty Claims Industry and their supply chain partners. We solve interesting and complex problems that directly affect the customers our clients serve. We are constantly adapting to stay on the forefront of emerging technologies and we work diligently to maintain our position as a thought leader within our industry. Mitchells workers compensation national managed care program offers solutions for insurance carriers, third:party administrators and employers. We recommend an integrated suite of solutions that include utilization review and case management with a focus on managing total claims costs while expediting safe return to work.This position requires an individual experienced in Medical Bill Review who, under minimal supervision, can independently analyze all incoming medical bills for usual and customary or fee schedule application and PPO interface, including re:evaluations, negotiated discounts, multi:state and multi:line of business medical bills, while meeting contracted client requirements. This individual needs to have strong written and communication skills to be able to handle provider disputes. Properly operates computers (hardware and software), while maintaining an acceptable speed and level of accuracy determined by company standards and Department manager. Responsibilities:Enter and independently review professional services from client submitted medical bills in bill review system covering:Medical bills in SmartadvisorAnalysis on all U and C exposuresAnalysis for 6+ assigned states having fee schedulesMulti:state JurisdictionMulti:Line BusinessHospital and Provider PPO application (including manual)Provider file maintenanceClaim file maintenanceHandle C/S calls as assignedHandle Re:evaluation disputes with providersIndependent research on usual and customary/fee schedule application and system terface 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.Successful completion of Billing Ops Analyst I position while consistently meeting the production and quality expectations of the Billing Ops Analyst II position for 90 days or relative plete knowledge of CPT/ICD:9/HCPCS/NDS codes.U and C bill review experience (6:9 months).Fee scheduling bill review experience (9:12) months.Multi:jurisdictional bill review experience (6+ fee schedule states).PPO re:pricing (6:9) months.H.S. Diploma or equivalent.10:key by touch.Strong written and communication skills.Knowledge of:CPT/ICD:9/HCPCS/NDS codes.Knowledge of usual and customary bill review application.Knowledge of fee scheduling bill review application.PPO (manual and automated) contract application.Multi:jurisdictional bill review experience (3+ fee schedule states).
• Location: coppell, North DFW
• Post ID: 52196783 northdfw