Repricing Associate (Temporary)

Description

The Repricing Associate will be responsible for data entry of billing information, verification of ICD-10 and CPT-4 codes and submission of reconsiderations. The Repricing Associate will report to the Workers’ Compensation Claims Manager.

This is a remote position and can be located anywhere in the United States.

This is a temporary position expected to last through Q2 of 2027.

Job Responsibilities

• Duties are not limited to the below and will expand over time.
• Responsible for data entry of billing and Medicare reporting while verifying ICD-10 and CPT-4 codes
• Research, respond and track inquiries in a timely manner to ensure compliance with state laws
• Handle Electronic Data Interchange (EDI) claim rejections and apply manual repricing as needed
• Process and administer reconsiderations and appeals while working with vendors and provider networks
• Research issues with provider returned checks, research provider reimbursement inquires and process these requests
• Participate in PPO Network and vendor quarterly oversight calls/meetings
• Cross train on all provider network tasks within the department
• Perform other duties as assigned

Requirements

Qualifications

Knowledge, Skills & Abilities:

• A thorough understanding of billing and coding procedures and a solid understanding of medical terminology
• Ability to work within turnaround time standards and state law requirements and implement them in the Medical Bill Repricing process
• Must be able to prepare comprehensive reports with little guidance
• Candidates must have the ability to work remotely and have strong computer experience
• High Level of Proficiency: excellent verbal/written communication, attention to detail and multi-tasking
• Approaches change as an opportunity for growth and development
• Ability to navigate multiple systems and screens simultaneously.
• Ability to work both independently and collaboratively within a virtual office environment
• Must have reliable internet
• Self-motivated and flexible
• Strong customer service skills
• Ability to independently manage workload, including prioritizing, and managing assignments to meet deadlines
• Proficiency with MS Word, Excel, Outlook, Teams, Slack, Zoom and internet applications

Education:

• College degree or college level education preferred

Experience:

• Candidates must have experience in a medical billing environment
• Familiar with Medicare/CMS requirements
• Coding Accreditations are a bonus

In accordance with pay transparency laws and regulations, the following good faith compensation range estimate is being provided. The salary range for this position is $24 - 29 per hour. Final compensation will be based on candidate qualifications, geographic location, and other considerations permitted by law.