Billing Analyst I - Broadspire

US-FL-SUNRISE
1 month ago
Requisition ID
2017-2356
Category
Finance & Accounting
Business Unit
Broadspire

Excellence In Everything We Touch

BSP

Position Summary

To efficiently and accurately audit bills according to standard Broadspire, State and/or National legislative and fee guidelines.

 

 

Responsibilities

 

  • Review and verify diagnosis codes, provider information, payer information, procedure codes and dates of service.
  • Identify bills requiring research and assign bill notes and/or explanation codes indicating the reason for additional research. Apply bill/form type, modifiers and units when necessary. Process duplicate bills according to standard procedures.
  • Enter bill information manually when required, calculating appropriate payment recommendation if necessary. Transfer bills that meet specific criteria; (i.e., surgical, ambulatory, etc). May consult with internal medical professionals to receive support for bill decisions to reduce legal exposure.
  • Review and interpret relevant medical information including medical records, treatment reports, operative reports, consultation reports, diagnostic evaluations and functional capacity evaluations to accurately determine adjudication.
  • Verify fee schedule and usual and customary rules according to state law or national guidelines. Apply advanced and/or proprietary reimbursement methodologies when appropriate.
  • Communicate with providers, trainers and peers verbally and in written form.
  • May perform other duties as assigned.

 

Requirements

 

  • 2 or more years work experience with CPT and ICD-9 codes or classroom experience is required.

  • Familiar with HFCA and UB92 forms.

  • Ability to problem solve, analyze, organize and prioritize work.

  • Strong reading comprehension, verbal and written communication skills required with Windows environment experience.

  • Must be able to produce a high volume of quality work, be organized, multi-tasked, and prioritize work.

 

About Us

Broadspire (www.choosebroadspire.com), a leading international third party administrator, provides risk management solutions designed to help clients improve their financial results. Broadspire offers casualty claim and medical management services to assist large organizations in achieving their unique goals, increasing employee productivity and reducing the cost of risk through professional expertise, technology and data analytics. As a Crawford Company, Broadspire is based Atlanta, Ga., with 85 locations throughout the United States. Services are offered by Crawford & Company under the Broadspire brand in Europe (www.Broadspire.eu), including the United Kingdom (www.BroadspireTPA.co.uk).

In addition to a competitive salary, Crawford offers you:

  • Career advancement potential locally, nationally and internationally. Crawford & Company has more than 700 locations in 70 countries;
  • On-going training opportunities through every stage of your career
  • Strong benefits package including matching 401k; health, dental, and life insurance; employee stock purchase plans; tuition reimbursement and so much more.

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. 

 

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