Job Summary : The Bill Processor is responsible for accurately reviewing, coding, and processing medical bills and invoices related to Workers' Compensation claims in compliance with Bureau of Workers Compensation guidelines. This role ensures timely payments, resolves billing issues through cross-department collaboration, and delivers excellent customer service to providers, attorneys, and injured workers. The position requires strong knowledge of ICD / CPT coding, Workers' Compensation policies, and proficiency in billing systems and documentation standards.
QUALIFICATIONS
- Knowledge and skills at a level normally acquired through the completion of a High School education or comparable work experience
- Certified Coding Credentials from one of the following : Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Associate (CCA), Certified Coding Specialist Physician-based (CCS-P), Certified Coding Specialist (CCS), Certified Professional Coder (CPC), Certified Professional Coder-Payer (CPC-P), Certified Inpatient Coder (CIC), or Certified Outpatient Coder (COC)
- Prefer 1 year Bureau of Workers Compensation or Worker's Comp experience
- Ability to handle sensitive information and maintain a high level of confidentiality
- Working knowledge of Miller criteria preferred (State, ex rel. Miller v. Industrial Commission, 1994, 71 Ohio St. 3d 229)
- Be proficient in MCO Policy Reference Guide and Billing and Reimbursement Manual
- Working knowledge of Bureau of Workers Compensation policies and procedures as they relate to bill payment
- Working knowledge of ICD and CPT codes as they relate to Workers Compensation Injuries
- Excellent written and communication skills
- Excellent Customer Service Skills
- Experience with various computer programs and data entry skills
- Ability to multi-task
ROLE AND RESPONSIBILITIES
Reports directly to the Operations Supervisor or the Billing Team LeaderProcess incoming bills / invoices that are received by fax, mail or electronically within the timeframes as set by the Bureau of Workers CompensationRequired to meet all quality and production requirementsMaintain communication between the billing department and other areas of the Managed Care Organization to resolve billing issuesProvide excellent customer service for bill related calls from providers, attorneys and Injured WorkersAssist with other departments as needed to facilitate the Managed Care Organization's work flowDemonstrates Sheakley Core ValuesAll other duties as assigned by Supervisor, Team Leader and / or ManagementThis job description is not intended to be all inclusive and the employee will also perform other reasonably related business duties as assigned by the immediate supervisor and other management as required.