Medical Bill Analyst (Workers Compensation)

Berkshire Hathaway Homestate Companies, Workers Compensation Division, has an immediate opening for a Medical Bill Analyst to join its Medical Management team. This individual is responsible for processing medical billing in accordance with jurisdictional regulatory requirements, while applying appropriate fee schedule and PPO reductions.

• Masters appropriate application of procedural (CPT) codes, diagnostic ICD-9 codes, diagnostic ICD-9-CM codes, Diagnosis Related Group (DRG) codes, Ambulatory Payment Classification (APC) codes, and modifiers. Exhibits continuous improvement under the guidance of the Medical Bill Review Supervisor, and demonstrates mastery of fundamental bill review knowledge and skills.
• Efficiently reviews medical bills and data reports for data accuracy and completeness.
• Examines bills for legibility and takes appropriate action to ensure accuracy of documentation.
• Accurately identifies data from claim information.
• Identifies and enforces jurisdictional regulatory billing standards and Company standards.
• Proactively communicates to Medical Bill Review Supervisor any problem or issue that may adversely impact a client or the Company.
• Ensures work is performed in accordance with Company standards, training, and supervisory direction to ensure compliance with corporate and regulatory standards.
• Fosters a positive and close working relationship with other Company staff, including Adjusting staff, other Medical Management staff, Special Investigations Unit, Legal, Lien Unit, Customer Care staff, and Client Services staff.

• Education: Minimum of High School diploma, or equivalent certificate, required. Associate's degree from an accredited college or university preferred.
• Experience: Prior experience in the field of medicine, including medical billing, preferred.
• Language Skills: Ability to read and interpret complex documents, including medical records, medical bills, medical resource materials, statutes, regulations, legal opinions, legal letters, claim notes, and claim data fields.
• Math Skills: Ability to calculate figures and amounts, such as discounts, interest, proportions, percentages, sums, differences, products, and volumes.
• Reasoning Skills: Ability to comply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations.
• Technical Skills: Ability to master regulatory requirements and practices of coding and workers compensation bill review in assigned jurisdictions.
• Certifications: One or more preferred: Certified Coding Specialist (CCS) with the American Health Information Management Association, Certified Professional Coder (CPC) with the American Academy of Professional Coders, or equivalent coding certification.

• Work-Life Balance
• Work From Home Program (up to 2 days per week upon eligibility)
• Free On-Site Fitness Facility
• Free On-Site Garage Parking

• Paid Time Off
• Paid Holidays
• Retirements Savings Match
• Group Health Insurance (Medical, Dental, and Vision)
• Life and AD&D Insurance
• Long Term Disability Insurance
• Paid Community Volunteer Day
• Employee Assistance Program
• Tuition Reimbursement Program
• Employee Referral Program
• Diversity, Equity and Inclusion Program

ABOUT US

With more than 50 years in business, BHHC has grown from a regional organization to a national insurance group, offering insurance products from coast to coast. Relationships are the cornerstone of our culture, and we believe in doing the right thing. That means we invest in our business in every way possible to deliver on our mission and demonstrate that people are what powers our success. Our commitment to financial strength and integrity means our customers can rest assured that we will be there when it counts.

At BHHC we embrace diversity and foster an environment where our people can be their authentic selves. Our differences make us stronger and better together, which fosters a harmonious workplace—something we truly value. We’ve created an approachable and collaborative atmosphere. Here you’ll find a welcoming workplace where everyone can feel valued, supported, and inspired to do great work. Together, we raise the bar by being curious, remaining customer-focused, and operating with integrity.

The starting hourly wage for this job is $17.00 . This hourly wage is what the employer reasonably expects to pay for the position based on potential employee qualifications, operational needs and other considerations consistent with applicable law. The pay scale applies only to this position and only if it is filled in Omaha, Nebraska. The pay scale may be different for other positions or in other locations.