Our Ideal Candidate
At WellRithms, we’re redefining medical reimbursement—and we need sharp, motivated professionals to help us lead the way. As a Bill Review Specialist, you’ll play a critical role in ensuring fair and accurate medical billing. You’ll apply WellRithms’ proprietary reimbursement methodology to review and process medical bills with precision. This is more than just a job—it’s an opportunity to deepen your expertise in medical billing and CPT coding while contributing to a mission-driven organization that values integrity and innovation. This role reports to the Bill Review Supervisor.
Responsibilities
- Analyze and evaluate medical bills to ensure accurate application of WellRithms’ reimbursement methodology within required timelines.
- Conduct detailed reviews of medical bills, supporting records, and itemized charges to determine fair and reasonable reimbursement.
- Verify and validate CPT, HCPCS, and other medical billing codes , ensuring correct usage and alignment with industry standards.
- Identify and correct billing discrepancies , collaborating with internal teams and leveraging established workflows to complete timely, high-quality reviews.
- Communicate directly with medical providers to request clarification, additional documentation, or corrections needed for accurate bill processing.
- Consistently meet daily productivity and quality assurance targets , maintaining accuracy in a fast-paced, time-sensitive environment.
- Support departmental needs by performing additional duties as assigned, contributing to continuous workflow improvement and operational efficiency.
Qualifications
High School diploma is required; some college is preferred.2-3 years of experience in healthcare or a related field is preferred.Knowledge of CPT coding and medical terminology.Familiarity with HCFA1500 and UB-04 billing forms.Excellent written and oral communication skills.Ability to meet deadlines in a time-sensitive environment.High comfort level with computers and software programs (MS Word, Excel, Outlook).CPC (Certified Professional Coding) education or certification is preferred.