Bill Review Associate IV at CompIQ-Philippines Branch

Pasay, Metro Manila, Philippines -

Full Time

Start Date

Immediate

Expiry Date

19 Aug, 26

Salary

0.0

Posted On

21 May, 26

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Medical Bill Review, Claims Analysis, Fee Schedule Application, PPO Reduction, Medicare Reduction, Quality Assurance, Compliance Monitoring, Stakeholder Communication, Medical Coding Knowledge, Reimbursement Analysis

Industry

Software Development

Description

Description Who we are… CompIQ Solutions is a software and full-service provider focusing on the property and casualty medical bill review market. We provide an end-to-end solution for our clients leveraging our proprietary technology and software platforms in the delivery of our solutions and services. We focus our efforts on our three key stakeholders, in this order: 1) Clients; 2) Colleagues; 3) Company. About this role The Medical Bill Review professional is responsible for analyzing and reviewing complex medical bills to determine accurate and compliant reimbursement outcomes using Fee Schedule, PPO, Usual & Customary, or Medicare reductions. This role handles high complexity claims such as appeals, surgical, hospital, and high-level office visit bills, while performing quality checks to ensure accuracy and consistency. The position ensures full compliance with fee schedule regulations, client-specific guidelines, and internal policies, and requires effective communication with internal teams and external stakeholders to resolve issues and maintain positive relationships. Requirements Duties & Responsibilities: Determines the appropriateness of a final reimbursement outcome by making the distinction between and knowing when to apply either Fee Schedule reduction, PPO reduction, Usual & Customary reduction, or Medicare reduction Analyzes and reviews. Process complex bills (Appeals, Surgery, Hospital, etc.,) high-level office visits, reports, and record reviews Perform quality checks on submitted bills, identify errors, and ensure accuracy of bill review processes. Ensure all bill review activities comply with all fee schedule regulations, client-specific guidelines, and internal policies. Effectively communicate with internal and external stakeholders, including clients, to resolve issues and maintain positive relationships. Ensure consistent application of company policies, billing procedures, and fee schedule guidelines.

Responsibilities

Analyze and review complex medical bills to determine accurate reimbursement outcomes using various reduction methods. Perform quality checks and ensure full compliance with fee schedule regulations and client guidelines.