Nurse Itemized Bill Reviewer, IBR Analyst
Job Description:
- Perform an in-depth review of medical claims utilizing the UB-04 and detailed itemized statement to ensure the validity of line-item charges.
- Verify accuracy of the itemized charges to be reimbursed according to client policy and industry standards.
- Validate automatic system denials and create additions to enhance efficient processing of IBR claims.
- Recommend system enhancements and edits to improve claim review efficiency.
- Comply with company standards regarding accuracy and productivity to manage daily assignments and meet client turnaround times.
- Consult with Senior Analysts with any questions and/or issues related to claim reviews.
- Assist in content development, automation, research, and appeal responses as needed.
- Provide input and collaboration concerning content development with internal groups and on global projects as needed.
- Attend all required meetings.
- Assists in special projects and perform other duties as needed.
Requirements:
- Active RN, LPN, or LVN license in good standing
- Equivalent experience of 1+ years in itemized bill review
- Equivalent experience of 2+ years in healthcare billing and coding
- Experience applying payer policies and national coding guidelines such as CPT, ICD-9/10, and HCPCS
- Ability to research and verify billing and coding accuracy
- Possess significant attention to detail and excellent written and verbal skills
- Excellent organizational, analytical, and problem-solving skills
- Capable of handling multiple projects in a fast paced, hyper-growth environment
- Strong ability to work independently and work with internal teams communicating change across the business
Benefits:
- Work from anywhere in the US! Machinify is digital-first.
- Top Medical/Dental/Vision offerings
- FSA/HSA
- Tuition reimbursement
- Competitive salary, 401(k) with company match
- Additional health and wellness benefits and perks
- Flexible and trusting environment where you’ll feel empowered to do your best work
