Workers Comp Appeals Analyst

TEKsystems
$22.00 - $25.00 / hr
United States, Florida, Tampa
Nov 08, 2024
Description: This person will be on the bill review team specifically working in the backlog of appeals. The Bill Review Analyst position holds accountability for accurate and timely review, processing and payment of bills to include pre-coding accuracy and adjudication of appeals/provider reconsideration requests. Prefer candidates to have worked in Mitchell Smart Advisor platform which is the largest workers comp program but open to similar programs as well. Skills: workers' compensation, appeals, bill review software Top Skills Details: workers' compensation,appeals,bill review software Additional Skills & Qualifications: Examines and adjudicates requests for appeals, reconsiderations, re-evaluations, and corrected bills. Maintains knowledge of industry standard medical coding initiatives and state specific fee schedules and coding guidelines Meets or exceeds department contractual and/or industry standards for accuracy and turnaround time Maintains an understanding of all variations of Workers' Compensation state rules and regulations Maintains comprehensive knowledge of all available re-pricing opportunities (e.g. PPOs, direct contracts, etc.), ensures application as part of the adjudication process Monitors itemized billings for excessive charges, duplications, and appropriate medical bills coding Reviews/processes appeals and initiates refund requests, assists in the recoupment process. Assists in the preparation of bills research reports About TEKsystems: We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company. The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.