Bill Review Specialist - Worker's Compensation

Paradigm is seeking a Bill Review Specialist to work in a remote (or hybrid if in Tampa, FL) position. The ideal candidate is detail-oriented, analytical, comfortable working with worker's compensation medical billing information, and proactive in identifying and resolving inconsistencies.The Bill Review Specialist supports accurate and timely processing of workers' compensation medical bills by reviewing billing documentation, researching payment issues, resolving discrepancies, and responding to billing inquiries. This role works closely with internal teams, providers, and clients to resolve issues and ensure billing accuracy and compliance.Key Responsibilities:

Research and resolve work comp medical billing, payment, discrepancy, appeal, and reconsideration issues.

Review work comp medical bills, supporting documentation, fee schedules, pricing, payments, and savings for accuracy.

Accurately enter, process, and maintain work comp medical bill information within bill review systems.

Communicate with providers, clients, and internal teams to obtain information and resolve billing issues.

Identify missing or inconsistent information and coordinate appropriate follow-up.

Build effective relationships with healthcare providers, PPOs, specialty providers, and ancillary service partners.

Serve as a billing and payment resource for internal clinical teams.

Support reporting, documentation, troubleshooting, process improvements, and compliance with applicable requirements.

Qualifications:

High School Diploma; successful completion of continuing education in insurance, medical terminology/coding, and/or accounting preferred2 years customer service experience with a minimum of 2 years worker's comp, healthcare, claims and/or bill review experience.Knowledge of Worker's Comp billing, including ICD-9/ICD-10; CPT; RVS; U&C; fee schedules; HCPCS and other coding schemes preferredIntermediate computer experience using Microsoft Word, Excel and Outlook requiredExcellent organizational skillsExcellent oral communication skills and phone presence. Ability to effectively present information to providers as well as to employees of the organizationAbility to define problems, collect data, establish facts, and draw valid conclusions. Ability to interpret a variety of instructions and deal with abstract and concrete variablesAny combination of education, experience and knowledge that demonstrate the ability to perform the functions of the position will be accepted.