Position Overview

The Itemized Bill Review Senior Analyst will be responsible for analyzing hospital claims for adherence to proper billing guidelines and will work closely with Expert Claims Review staff to efficiently adhere to policies and procedures for claims processing. This position will also be responsible for training and developing new team associates, report management, and acceptance of claims above the team members’ threshold once analysis is complete. Assisting the manager and the team in areas of need will be required.

Key responsibilities:

Responsible for conducting detailed review of hospital itemized bills for identification of billing and coding opportunities for all payor’s claims.

Prepare and upload documentation clearly identifying findings.

Accurately calculate/verify the value of compliance edits and documentation for claim processing.

Monitor multiple reports to track client specific requirements, turnaround time a...