Retro Billing Assoc II

Posted Feb 22

Retro Billing Assoc II

We’re looking for colleagues who are ready to Think Big, Go Fast, Deliver Awe, and Win Together. These core values embody our diverse and inclusive culture and help us live out our mission of “getting people the care they need when they need it.” Over the last 30 years, our company has established itself as the market leader in managed care for the workers’ compensation industry. We are committed to making a positive impact in the lives of the injured workers we serve, and we have fun doing it. 

Salary Range: $17.75 - $26.7 Hourly

This compensation range takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs. The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the position may be filled. At One Call, it is not typical for an individual to be hired at or near the top of the range for their role and compensation decisions are dependent on the facts and circumstances of each case. A reasonable estimate of the current range is $17.75 - $26.7 Hourly

Benefits Summary: 

In return for your commitment to our company’s mission, we offer a vast array of benefits to help support the whole you. 

·       Opportunities to work from home 

·       Competitive wages with opportunities to earn annual merit increases 

·       Paid development hours to use for professional and community development! 

·       Generous paid time off, 8 company holidays, and 2 personal days per year 

·       $1,000 Colleague Referral Program 

·       Enterprise Recognition Program rewarding colleagues for their extraordinary work 

·       Exclusive discounts on travel, activities, and merchandise via work discount program 

·       Colleague Assistance Program that provides free counseling and financial services 

·       Tuition Reimbursement Program including certifications 

·       Quantum Health: A healthcare navigation platform to help our colleagues make the best, most cost-effective healthcare decisions 

·       Medical, dental, and vision insurance 

·       Pre-Tax FSA and HSA health savings accounts 

·       401(k) matching 

·       Company paid life insurance 

·       Company paid short term and long-term disability 

·       Referral program

·       Healthcare concierge 

·       The One Call Foundation which aims to help colleagues during unexpected emergencies, from car accidents to natural disasters. 

JOB SUMMARY: 

The Retro Billing Associate reviews bills submitted by payors and channel partners via One Call’s retrospective program. Associates follow state and federal guidelines, fee schedules, and customer-specific rules to obtain enhanced savings for our clients. Associates interact with Providers and Claim Professionals as necessary to deliver accurate and efficient bill processing. Communicates timely responses to inquiries from Internal and External customers.

Retro Billing Associate II 

Intermediate role. Moderate skills with high level of proficiency. Performs billing resolution processing and handles inquiries. Questions and issues are predominantly routine, but associate must be able to deviate from standard scripts and procedures as needed. Assists with resolving billing related issues within the department. May coach and share information with associates with less experience and/or expertise. Works under close to general supervision with little latitude for independent judgment. May consult with senior peers and team leads to learn through experience. Requires a High School diploma and typically a minimum of 1 to 3 years of experience in an office setting and/or billing experience. 

GENERAL DUTIES & RESPONSIBILITIES:  

  • Learns or remains current on billing protocols and regulations, federal and state regulations, and internal procedures that affect processing 
  • Provides subject matter expertise on billing and coding guidelines and regulations as required by the department 
  • Uses internal and external billing protocols and regulations for repricing bills at a cost savings to the customer 
  • Identifies trending opportunities related to policies and procedures to ensure efficiency and accuracy in bill processing 
  • Reviews, researches, and initiates the resolution of billing errors 
  • Reviews, researches, and resolves customer-related inquiries 
  • Develops/maintains process documentation for each assigned task 
  • Communicates with appropriate internal departments to solve issues and discrepancies 
  • Performs other related duties as assigned 

EDUCATIONAL AND EXPERIENCE REQUIREMENTS: 

  • High school diploma/GED required.

GENERAL KNOWLEDGE, SKILLS & ABILITIES:

  • Knowledge of Billing rules and regulations and federal and state regulations
  • Excellent customer service skills that build high levels of customer satisfaction 
  • Effective verbal and written communication skills 
  • Computer navigation and operation skills
  • Detail-oriented with good organizational skills
  • Ability to manage multiple tasks
  • Ability to work both independently and in a team environment
  • Ability to maintain confidentiality
  • Proficient with Microsoft Office

PHYSICAL/EMOTIONAL DEMANDS & WORK ENVIRONMENT: 

For roles located in office or home settings; this job is primarily sedentary and may involve repetitive motions. The employee is regularly required to sit, use hands and fingers, speak, and hear.

  • The employee is occasionally required to stand, walk, and lift objects (up to 10 lbs. weight; up to 4 ft. height).  
  • Specific vision abilities required by this job include ability to see things from a close distance and ability to adjust focus.
  • The in-office work environment utilizes florescent lighting; noise level is moderate.
  •  The emotional demand of the job may cause undue stress from, but not limited to, regular weekly/bi-weekly/quarterly/year end deadlines, and a moderate/heavy workload.
  • Reasonable accommodations will be individually assessed and possibly made to enable individuals with disabilities to perform the essential functions of the position. 
  • Please be advised the job description is subject to change at any time.