Repricing Associate (Temporary)

Accountabilities Medical billing and data entry: Enter billing information and Medicare reporting data accurately while verifying ICD-10 and CPT-4 codes to support appropriate medical bill repricing.

Regulatory compliance: Research and respond to inquiries within established turnaround times, ensuring compliance with applicable state laws and Medicare requirements.

EDI claims processing: Investigate electronic data interchange (EDI) claim rejections, resolve processing issues, and apply manual repricing when necessary.

Reconsiderations and appeals: Process and administer billing reconsiderations and appeals, coordinating with vendors and provider networks to support timely and accurate resolutions.

Provider payment investigations: Research returned provider checks, investigate reimbursement inquiries, and process requests related to payment discrepancies.

Reporting and documentation: Prepare comprehensive reports, maintain accurate records, and track inquiries and assigned tasks with minimal supervision.

Vendor and network coordination: Participate in quarterly oversight meetings with preferred provider organization (PPO) networks and vendors to support effective collaboration and service quality.

Cross-functional support: Cross-train on provider network responsibilities within the department and assist with additional operational duties as business needs evolve.

Workflow and workload management: Prioritize assignments, navigate multiple systems simultaneously, and consistently meet deadlines and service standards.

Customer service: Communicate professionally with internal and external stakeholders to resolve questions, clarify billing issues, and maintain positive working relationships.

Requirements

Medical billing experience: Previous experience working in a medical billing environment is required.

Education: A college degree or college-level education is preferred.

Medical coding knowledge: A thorough understanding of billing and coding procedures, including familiarity with ICD-10 and CPT-4 codes, and a solid understanding of medical terminology.

Medicare knowledge: Familiarity with Medicare and Centers for Medicare & Medicaid Services (CMS) requirements is necessary.

Coding certifications: Relevant medical coding accreditations are an advantage.

Regulatory awareness: Ability to apply state-specific requirements, compliance standards, and turnaround time expectations to medical bill repricing activities.

Technical proficiency: Strong computer skills and the ability to navigate multiple software applications and screens efficiently.

Microsoft Office and collaboration tools: Proficiency with Microsoft Word, Excel, Outlook, Teams, Slack, Zoom, and internet-based applications.

Analytical and reporting skills: Ability to investigate billing and reimbursement discrepancies, prepare detailed reports, and manage assigned tasks with minimal guidance.

Communication skills: Excellent written and verbal communication skills, with the ability to interact professionally with providers, vendors, and internal colleagues.

Attention to detail: Strong organizational skills and a commitment to accurate data entry, coding verification, documentation, and claims processing.

Time management: Ability to multitask, prioritize competing assignments, and meet deadlines in a fast-paced environment.

Independent and collaborative working style: Comfortable working autonomously while contributing effectively to a virtual team.

Adaptability: A flexible, self-motivated approach and a willingness to embrace changing priorities, learn new processes, and cross-train on departmental responsibilities.

Remote work readiness: Reliable internet access and the ability to work effectively in a fully remote environment.

Customer service orientation: Strong service skills and a proactive approach to resolving inquiries and addressing stakeholder concerns.

Benefits

Competitive hourly pay: $24–$29 per hour, depending on qualifications, geographic location, and other applicable factors.

Fully remote work: Work from anywhere in the United States.

Full-time temporary opportunity: Expected duration through Q2 2027.

Professional experience: Gain hands-on experience in medical bill repricing, workers' compensation claims operations, Medicare reporting, and reimbursement processes.

Cross-training opportunities: Develop broader knowledge of provider network operations and related departmental responsibilities.

Collaborative virtual environment: Work with internal teams, external vendors, and healthcare provider networks.

Skill development: Strengthen your expertise in medical coding verification, regulatory compliance, claims reconsiderations, and billing issue resolution.

How Jobgether works: We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team. We appreciate your interest and wish you the best!  Why Apply Through Jobgether? 

Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time.

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