Billing Operations Analyst 1

$34,154 - $48,360/Yr

Unclassified - Tucson, AZ

Part-time - Entry Level

Tucson, AZ

About the position

The Billing Operations Analyst 1 position at Coventry WCS is designed for individuals with a foundational understanding of medical billing processes. This role requires the analyst to independently analyze incoming medical bills, ensuring compliance with usual and customary rates, fee schedules, and PPO interfaces. The analyst will be responsible for reviewing a variety of medical bills, including those from multiple states and lines of business, while adhering to client requirements. The position demands strong analytical skills and the ability to communicate effectively, particularly when handling provider disputes. The analyst will also be expected to operate various computer systems efficiently, maintaining accuracy and speed as per company standards. In this role, the analyst will enter and review professional services from client-submitted medical bills using the bill review system. This includes analyzing medical bills in Smartadvisor and other billing systems, managing claims and provider files, and conducting independent research on fee schedules and customary rates. The analyst will also handle customer service calls, manage re-evaluation disputes, and provide training and quality reviews for co-workers. The position is entry-level, making it suitable for candidates with less than a year of experience in medical billing, but who possess the necessary skills and attention to detail to succeed in this fast-paced environment.

Responsibilities

• Enter and independently review professional services from client submitted medical bills in bill review system.
• Analyze medical bills in Smartadvisor and other billing systems.
• Conduct analysis on all usual and customary exposures.
• Manage analysis for 6+ assigned states having fee schedules.
• Handle multi-state jurisdiction and multi-line business medical bills.
• Apply hospital and provider PPO applications, including manual processes.
• Maintain provider and claim files.
• Handle customer service calls as assigned.
• Manage re-evaluation disputes with providers and clients.
• Conduct independent research on usual and customary/fee schedule applications and system interfaces.
• Interface in training co-workers.
• Provide quality review as assigned by Lead/Supervisor.
• Offer feedback type training in quality assurance of work product from co-workers.

Requirements

• High school diploma or GED required.
• 6 months to 1 year of medical billing experience.
• Knowledge of CPT/HCPCS codes.
• Understanding of usual and customary rates.
• Familiarity with fee scheduling.
• Strong attention to detail.
• Proficient in 10-key typing by touch.
• Strong written and communication skills.
• Strong analytical and problem-solving skills.

Benefits

• Health savings account
• AD&D insurance
• Health insurance
• Dental insurance
• 401(k)
• Flexible spending account
• Tuition reimbursement
• Vision insurance