Bill Review Complex Analyst, Risk Management - Lakeland
Publix
The purpose of this position is to analyze and review medical bills for adjudication of invoices for Publix associates injured in Workers Compensation accidents. The Bill Review Analyst is responsible for ensuring bills are paid in a timely manner and in accordance with the Workers Compensation laws of the states in which Publix does business in.
Responsibilities:reviewing and analyzing medical bills to confirm whether treatment rendered was authorized by the adjuster or medical case manager is appropriate for the type of injury sustained, and that the fees invoiced are standard and equitable, follow appropriate schedules and regulations, and align with previous contracted agreementsmanually reviewing and resolving issues on medical bills that are flagged as requiring more in-depth review, or which cannot otherwise be re-priced to the appropriate state workers’ compensation fee schedule by our automated medical bill review systemcommunicating directly with vendors and medical providers that challenge the amount reimbursedprovide customer service to providers, Publix managers, and associates that contact Risk Management regarding the payment or non-payment of bills
Responsibilities:reviewing and analyzing medical bills to confirm whether treatment rendered was authorized by the adjuster or medical case manager is appropriate for the type of injury sustained, and that the fees invoiced are standard and equitable, follow appropriate schedules and regulations, and align with previous contracted agreementsmanually reviewing and resolving issues on medical bills that are flagged as requiring more in-depth review, or which cannot otherwise be re-priced to the appropriate state workers’ compensation fee schedule by our automated medical bill review systemcommunicating directly with vendors and medical providers that challenge the amount reimbursedprovide customer service to providers, Publix managers, and associates that contact Risk Management regarding the payment or non-payment of bills
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