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Medical Billing Review Analyst
2 months ago
The Healthcare Charge Review Specialist is responsible for evaluating medical services to assess the validity of charges on various medical invoices, ensuring the appropriateness of healthcare provided.
Candidates must reside in the greater Charlotte, NC area and be available for in-office training for at least one week at the beginning of employment.
KEY RESPONSIBILITIES:
Determine the necessity of the review process and relay any specific concerns to the claims examiner or direct supervisor. Gather relevant data and assess information to make informed decisions regarding the appropriateness of billing, care delivery, and treatment strategies. Accurately document work and final determinations in the designated software system. Maintain regular and consistent attendance. Adhere to all safety protocols and regulations during work hours in alignment with the Injury and Illness Prevention Program (IIPP). Perform additional tasks as assigned.REQUIRED KNOWLEDGE & SKILLS:
Comprehensive understanding of ICD Diagnosis and Procedure Codes, as well as C.P.T., along with a solid grasp of medical terminology. Familiarity with relevant fee schedules and applicable U&C Guidelines. Proficient in Microsoft Office applications and possess the technical aptitude to enhance knowledge and proficiency in CorVel's proprietary systems. Ability to work autonomously, adhere to process guidelines, and meet productivity benchmarks and deadlines. (Must maintain a performance audit score of 98% or higher.)EDUCATION & EXPERIENCE:
Associate's degree or equivalent professional experience. CPC or CPC-A certification is mandatory. Previous experience in the following areas is preferred: Medical billing audits, knowledge of the workers' compensation claims process, and utilization review (prospective, concurrent, and retrospective).COMPENSATION:
CorVel employs a market-based approach to compensation, and our salary ranges may differ based on geographic location. Pay rates are determined by factors such as federal, state, and local minimum wage laws, geographic location differentials, job-related skills, experience, qualifications, internal equity, and market conditions. These ranges are subject to change.
For roles with multiple levels (I, II, III, Senior, Lead, etc.), new hires may be placed at a different level, either higher or lower, based on assessments during the interview process, considering experience, qualifications, and overall suitability for the position. The level may influence the salary range, and these adjustments will be clarified during the offer process.
Pay Range: $36.79 per hour.
A comprehensive list of our benefits can be found on the CorVel website: CorVel Careers | Opportunities in Risk Management.
About CorVel:
CorVel, recognized as a certified Great Place to Work Company, is a national leader in providing innovative risk management solutions across the workers' compensation, auto, health, and disability management sectors. Established in 1987 and publicly traded on the NASDAQ since 1991, our ongoing investment in human capital and technology allows us to deliver cutting-edge and integrated solutions to our clients. We are a stable and expanding organization with a strong, supportive culture and numerous opportunities for career advancement. Over 4,000 employees across the United States uphold our core values of Accountability, Commitment, Excellence, Integrity, and Teamwork (ACE-IT).
A comprehensive benefits package is available for full-time regular employees, including Medical (HDHP) with Pharmacy, Dental, Vision, Long-Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off.
CorVel is an Equal Opportunity Employer, maintains a drug-free workplace, and complies with ADA regulations as applicable.
