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Excellence In Everything We Touch
Position Summary
To maintain the accuracy and integrity of all bills in the Medical Bill Review System. Ensure timely and most efficient flow of bills through all systems documenting issues that are identified, addressed and resolved. Performs business and productivity analyses, conducts research and studies, and develops methods and procedures for prioritizing and assessing both manual and automated processes. Make recommendations to improve assigned area’s effectiveness and efficiency.
Responsibilities
• Process all bills that are flagged for review based on system generated edits in place as determined by rules for each Medical Bill Review account.
• Review all automated reports and work bills according to Standard Operating Procedures and workflows.
• Review and monitor the import, export and processing of all bills through Bill Review System and its Support Vendors including Preferred Provider Networks. Ensure no interruption in processing based on standard turnaround times and acceptable output files. Work primarily with
• Information Technology when issues arise.
• Provides various data and information to the business units to enable the departments to make appropriate business decisions to meet department and corporate objectives.
• Manage duplicate and erroneous accounts found on the Duplicate Accounts and Account Error Reports utilizing Account Management System and Account bulletin.
• Submit for approval and process any bills with an allowance over $50,000.
• Keeps Supervisor informed verbally and in writing of activities and problems within assigned area of responsibility; refers matters beyond limits of authority and expertise to Supervisor for direction.
• Utilizes existing analytical tools, analyzes and measures results of new product or work flow strategies implemented to identify effectiveness.
• Perform other duties as required or requested.
Requirements
• Associate’s degree in Business or equivalent combination of education or work experience.
• A minimum of two (2) years of Medical Bill Review experience preferred with basic knowledge of medical terminology, CPT and ICD-9 coding.
• Demonstrated working knowledge of bill review processes, workflows and operating procedures.
• Demonstrates effective and diplomatic oral and written communication skills, including the ability to develop and deliver information and respond to questions from all levels of the organization.
• Must possess good research, analytical, decision making, problem solving and detail oriented skills. Must be well organized with good time management skills. Knowledge of Medical Bill Review systems and MS Office is required. Medical Bill Review System Interface knowledge and Crystal Reports is preferred.
About Us
Why Crawford?
Because a claim is more than a number — it’s a person, a child, a friend. It’s anyone who looks to Crawford on their worst days. And by helping to restore their lives, we are helping to restore our community – one claim at a time.
At Crawford, employees are empowered to grow, emboldened to act and inspired to innovate. Our industry-leading team pioneers new solutions for the industries and customers we serve. We’re looking for the next generation of leaders to take this journey with us.
We hail from more than 70 countries and speak dozens of languages, reflecting the global fabric of the audience we serve. Though our reach is vast, we proudly operate as One Crawford: united in purpose, vision and values. Learn more at www.crawco.com.
When you accept a job with Crawford, you become a part of the One Crawford family.
• Our total compensation plans provide each of our employees with far more than just a great salary
• Pay and incentive plans that recognize performance excellence
• Benefit programs that empower financial, physical, and mental wellness
• Training programs that promote continuous learning and career progression while enhancing job performance
• Sustainability programs that give back to the communities in which we live and work
• A culture of respect, collaboration, entrepreneurial spirit and inclusion
Crawford & Company participates in E-Verify and is an Equal Opportunity Employer. M/F/D/V Crawford & Company is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at Crawford via-email, the Internet or in any form and/or method without a valid written Statement of Work in place for this position from Crawford HR/Recruitment will be deemed the sole property of Crawford. No fee will be paid in the event the candidate is hired by Crawford as a result of the referral or through other means.
