What are the responsibilities and job description for the Medical Bill Reviewer (Hybrid) position at SCI Summit Consulting, LLC?
Headquartered in the Central Florida city of Lakeland, Summit employs over 700 office and field associates at its main location and regional offices in Baton Rouge, Louisiana, and Gainesville, Georgia. As the people who know workers’ comp, we strive to provide an atmosphere of constant growth and development for our employees. Summit provides workers’ compensation programs and services to thousands of employers throughout the Southeast. Summit is a member of Great American Insurance Group, a company that focuses on building relationships and linking people to various career paths. Whether it’s underwriting, claims, accounting, IT, legal, or customer service, Great American Insurance Group combines a small-company entrepreneurial atmosphere with big- company expertise. Essential Job Functions and Responsibilities Audits medical charges to ensure appropriate reimbursement in accordance with state fee schedules or usual and customary guidelines. Determines relatedness, causality and appropriateness of treatment based on the compensable injury. Identifies potential fraudulent claims and assists adjusters with SIU (Special Investigation Unit) referrals. Handles telephone and written customer service inquiries. Makes claim referral decisions of a limited scope. Enters data into claim document files. Performs other duties as assigned. The person hired for this position will work out of the Lakeland, FL office which offers a hybrid work environment of 3 days in the office and 2 days work from home. Job Requirements Education: High school diploma or equivalent Experience: Generally, 1 to 3 years of related experience. Company: SCI Summit Consulting, LLC Benefits: We offer competitive healthcare, retirement, and paid time off benefits for full-time and part-time benefit eligible employees. Headquartered in the Central Florida city of Lakeland, Summit employs over 700 office and field associates at its main location and regional offices in Baton Rouge, Louisiana, and Gainesville, Georgia. As the people who know workers’ comp, we strive to provide an atmosphere of constant growth and development for our employees. With more than 40 years of experience, Summit provides workers’ compensation programs and services to thousands of employers throughout the Southeast. Summit is a member of Great American Insurance Group, a company that focuses on building relationships and linking people to various career paths. Whether it’s underwriting, claims, accounting, IT, legal, or customer service, Great American Insurance Group combines a small-company entrepreneurial atmosphere with big- company expertise. https://www.summitholdings.com/site/tp/CAREER_SEEKERS
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