Utilization review nurse [h1.location_city]

Job Description

Job Description

We are looking for a skilled Medical Billing Specialist to join our team in Glen Allen, Virginia. In this Contract to permanent position, you will play a key role in ensuring medical bills align with state fee schedules, customer guidelines, and organizational discounts. This is an excellent opportunity for professionals with a strong background in medical billing and claims review.

Responsibilities :

• Audit medical bills to ensure compliance with state fee schedules, customer guidelines, and organizational discount policies.
• Utilize knowledge of fee schedules and computer systems to perform accurate bill reviews.
• Refer to relevant resources and materials when conducting audits to ensure accuracy.
• Maintain consistent attendance and adherence to organizational policies.
• Ensure compliance with safety standards and regulations as part of the Injury and Illness Prevention Program.
• Perform additional duties and responsibilities as assigned to support team objectives
• Minimum of 3 years of experience in medical billing, claims review, or a related field.
• Proficient in using tools such as Allscripts, Cerner Technologies, and Dynamic Data Exchange (DDE).
• Familiarity with EHR systems and platforms like Epaces.
• Strong knowledge of accounts receivable processes, appeals, and benefit functions.
• Expertise in billing functions, claim administration, and workers’ compensation procedures.
• Excellent attention to detail and ability to work independently in a fast-paced environment.