Itemized Bill Review Facility Reviewer
Company: Zelis Healthcare Corporation
Posted on: September 17, 2021
The Itemized Bill Review Facility Reviewer will be responsible
for analyzing facility inpatient and outpatient claims for Health
Plans and ensuring adherence to proper billing guidelines. They
will work closely with Hospital Bill Review, leadership and concept
development staff to efficiently identify and adhere to policies
and procedures for claims processing. This position will also be
responsible for developing new concepts, assisting with the quality
assurance program, and being a resource for the entire organization
regarding IBR claims. This will be a production based role with
production metrics adhered to.
Responsible for conducting detailed review of hospital itemized
bills for identification of billing and coding opportunities for
all payors claims including restricted list.
Review client payment policy documents. Interpret and document the
configurations to be applied to Zelis coding and clinical
Translate client reimbursement policies into Zelis coding and
Provide direction to internal team based on understanding of client
Understand payor policies and their application to claims
Keywords: Zelis Healthcare Corporation, Newark , Itemized Bill Review Facility Reviewer, Other , Bedminster, New Jersey
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