Nurse Itemized Bill Reviewer (IBR Analyst)

The role

You will review facility insurance claims to determine true and accurate charges. This involves analyzing UB-04 forms, itemized statements, and medical documentation using client policy and industry standards.

What you will do

• Perform an in-depth review of medical claims utilizing the UB-04 and detailed itemized statement
• Verify accuracy of the itemized charges to be reimbursed according to client policy and industry standards
• Validate automatic system denials and create additions to enhance efficient processing of IBR claims
• Recommend system enhancements and edits to improve claim review efficiency
• Comply with company standards regarding accuracy and productivity
• Consult with Senior Analysts with any questions and/or issues related to claim reviews
• Assist in content development, automation, research, and appeal responses as needed
• Provide input and collaboration concerning content development with internal groups and on global projects
• Attend all required meetings
• Assists in special projects and perform other duties as needed

Required qualifications

• Active RN, LPN, or LVN license in good standing
• 1+ years in itemized bill review
• 2+ years in healthcare billing and coding
• Experience applying payer policies and national coding guidelines such as CPT, ICD-9/10, and HCPCS
• Ability to research and verify billing and coding accuracy
• Significant attention to detail
• Excellent written and verbal skills
• Excellent organizational, analytical, and problem-solving skills
• Capable of handling multiple projects in a fast paced, hyper-growth environment
• Strong ability to work independently and work with internal teams
• Experience working with multiple monitors
• Proven success in a remote working environment

Benefits

• Top Medical/Dental/Vision offerings
• FSA/HSA
• Tuition reimbursement
• Competitive salary
• 401(k) with company match
• Additional health and wellness benefits and perks

About the company

Machinify is a healthcare intelligence company that delivers value, transparency, and efficiency to health plan clients. It uses an AI-powered platform to maximize financial outcomes and drive down healthcare costs.