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Medical Bill Reviewer I at Sentry Insurance in Stevens Point, WI
Skills
Job Description
This position will be staffed out of our Stevens Point, WI office and is NOT available for remote work.
What You'll Do
As a Medical Bill Reviewer I, you will:
Review, and evaluate in accordance with state regulations and established guidelines, processes original medical, dental, and pharmacy bills.
Evaluate bill data in compliance with medical bill processing guidelines. Identifies errors and makes corrections when possible. Determines the completeness of a bill and evaluates whether the bill can be sent back to the provider for required information in accordance with state guidelines.
Complete and submit state mandated forms regarding bill review reductions and/or denials in accordance with jurisdictional requirements.
Review and issue payment of vendor bills related to claim handling which may include bills for mileage, copy service, court reporters, IME, surveillance, non-emergency transportation, interpreter, utilization review, non-medical consulting, nurse case manager, etc.
Use state reference guides and websites, medical bill coding reference material, and rules built into the bill paying system to determine appropriate resolution and payment of billed item. Researches and analyzes provider NPIs/license numbers.
Additionally, you will:
Responds to inquiries from, medical providers, attorneys, insured, claimants, and other internal company employees regarding payment for services provided.
May communicate with medical providers regarding payment or denial of payment.
What it Takes
Technical Degree or equivalent work experience
Technical diploma or Associate Degree in Health Informatics/Health Information/Medical Coding preferred
High level of communication, customer services and telephone skills required
1 or more years of related work experience in a medical office, insurance environment, or medical coding beneficial
Basic knowledge of ICD9/IDC10, CPT, HCPCS codes necessary for accurate processing
PC knowledge including Excel as well as keyboarding, math aptitude, and organizational skills
Proficient analytical and decision making skills with the ability to work independently
Ability to work within deadlines, maintain confidentiality, and work with detail and a high level of accuracy is essential
What You'll Receive
At Sentry, your total rewards go beyond competitive compensation. Below are some benefits and perks that you’ll receive.
Sentry is happy to offer flexibility through a scheduled Hybrid work model. Monday and Friday work from home if you choose to, Tuesday through Thursday you’ll work in office.
As a Sentry associate, you will have an in-office workspace and materials for your home office. In addition to the laptop, you will receive prior to your start, Sentry will provide equipment for your home office.
Meal Subsidy available for associates who report to an office.
401(K) plan with a dollar for dollar match on your first eight percent, plus immediate vesting to help strengthen your financial future.
Continue your education and career development through Sentry University (SentryU) and utilize our Tuition Reimbursement program
Generous Paid-Time Off plan for you to enjoy time out of the office as well as Volunteer-Time off
Group Medical, Dental, Vision, Life insurance, Parental leave, and our Health and Wellness benefits to encourage a healthy lifestyle.
Well-being and Employee Assistance programs
Sentry Foundation gift matching program to encourage charitable giving.
About Sentry
We take great pride in making Forbes’ list of America’s Best Midsize Employers. A lot of different factors go into that honor, many of which contribute to your job satisfaction.
Our bright future is built on a long track record of success. We got our start in 1904 and have been helping businesses succeed and protect their futures ever since. Because of the trust placed in us, we’re one of the largest and financially strongest mutual insurance companies in the United States. We’re rated A+ by A.M. Best, the industry's leading rating authority.
Our headquarters is in Stevens Point, Wisconsin, with offices located throughout the United States. From sales to claims, and information technology to marketing, we enjoy a rewarding and challenging work environment with opportunities for ongoing professional development and growth.
Get ready to own your future at Sentry. Opportunities await!
Associate Talent Acquisition Specialist
Tha Xiong
Tha.Xiong@sentry.com
Equal Employment Opportunity
Sentry is an Equal Opportunity Employer. It is our policy that there be no discrimination in employment based on race, color, national origin, religion, sex, disability, age, marital status, or sexual orientation.