JOB OPPORTUNITIES

Coding and Cost Containment Technician

CompServices has been in existence since 1992 and is an established workers’ compensation third party administrator in the Commonwealth of Pennsylvania and a Managed Care Organization (MCO) in New Jersey. As a wholly owned subsidiary of one of the largest health insurers in the eastern part of Pennsylvania, we recognize the value of providing a continuum of care within a community. Our mission and philosophy is to arrange for the provisions of prompt health care to injured employees while recognizing the dual goal of wellness and returning the employee back to active duty at the earliest medically appropriate time.

We are currently seeking a Coding and Cost Containment Technician for our Pittsburgh, PA location.

Responsibilities

This individual will perform initial screening, evaluation, and on-line error and entry correction of workers’ compensation medical bills. In addition, he/she will screen and evaluate bills for provider services. This includes determining if all billing information is complete and correct, evaluating any missing information in order to process the bill, and applying all relevant guidelines that pertain to the evaluation of reported services.

All responsibilities are to be completed according to the jurisdictional requirements of the workers’ compensation law involving both medical bill cost containment and utilization review for three (3) jurisdictions:

• Telephoning appropriate parties to collect relevant information;
• Handling calls from medical providers and internal and external customers regarding the status of bills or amount of reimbursement;
• Answering questions as to why reimbursement was made at a particular level.

Qualifications

• High School diploma or equivalent;
• Three years in workers’ compensation claims;
• Detailed knowledge of PA Workers’ Compensation law and the claims process, with excellent procedure code and medical cost containment knowledge;
• Good data entry skills;
• Ability to apply pertinent workers’ compensation policies in evaluating and handling medical bills and cost containment at all levels of complexity;
• In-depth knowledge of utilization review and applications, and familiarity with PA W.C. Bureau’s Utilization Review process;
• Good analytical, communication, interpersonal, and marketing skills, as well as tact and diplomacy.

Contact Us

To learn more about CompServices, Inc., visit www.compservicesinc.com.  Email resume with salary requirements (please insert Code: MBR-022810-CH in the subject line of your email) to recruiter_8@ibx.com. EOE

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