Medical Bill Specialist

As a member of the Customer Service Center Medical Bill Team, ensure efficient and timely processing of all work assignments into applicable business systems with strict adherence to all established procedures to assist in the attainment of service level goals throughout the CSC.

Responsibilities:

• Review Pennsylvania Fee Review determinations and make interest payments on adverse fee review decisions.
• Review resubmitted medical bills in and process additional payments or denials based upon documentation.
• Handle medical bill overpayments and perform appropriate follow up work via telephone and written correspondence to ensure refund is received.
• Provide support and back up assistance to other areas of CSC as needed
• Demonstrate commitment to Company's Code of Business Conduct and Ethics, and apply knowledge of compliance policies and procedures, standards and laws applicable to job responsibilities in the performance of work.

• High School diploma or equivalent
• Prior insurance work experience, working knowledge of PMA business systems a plus
• Excellent communication and organizational skills
• Ability to problem solve; work independently
• Strong analytical skills with a focus on attention to detail.
• Knowledge of medical terminology, billing and coding beneficial