Demo

Bill Review Service Associate

First Managed Care Option
Hills, NJ Full Time
POSTED ON 1/26/2025
AVAILABLE BEFORE 3/26/2025

First Managed Care Option, Inc. is currently looking to hire a Bill Review Service Associate to support our Workers’ Compensation Bill Review Services Department to assist with reviewing Workers' Compensation Medical Bills in accordance with Medicare, state regulations and department objectives.

As a Bill Review Service Associate, you’ll perform a review of medical bills submitted to our Workers' Compensation department to ensure correct billing and payment practices. Additionally, you’ll:

  • Review, evaluate, and process workers’ compensation bills.
  • Follow established state and federal medical bill review rules and regulations.
  • Communicate with medical providers regarding payment or denial of payment.
  • Research and interpret state fee schedules.
  • Complete routine bill review activities for accurate pricing and payment of medical bills
  • Research and interpret Medicare rules and regulations.
  • Perform provider payment negotiations in accordance with First MCO policies, Medicare fee schedule, Usual & Customary fee schedules and state regulations.
  • Ability to work within deadlines, maintain confidentiality in accordance with HIPAA guidelines.

Must:

  • Be detail oriented with a high level of accuracy.
  • Have a high level of experience with Microsoft Word and Excel.
  • Have high level of verbal and written communication, customer service, and telephone skills required.

First Managed Care Option, Inc., is an Equal Opportunity Employer and takes pride in maintaining a diverse environment. We do not discriminate in recruitment, hiring, training, promotion or any other employment practices for reasons of race, color, religion, gender, national origin, age, sexual orientation, marital or veteran status, disability, or any other legally protected status.

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