Medical Bill Reviewer (Hybrid) Job at Summit Consulting, LLC
Headquartered in the Central Florida city of Lakeland, Summit employs over 700 office and field associates at its main location and regional offices in Baton Rouge, Louisiana, and Gainesville, Georgia. As the people who know workers’ comp, we strive to provide an atmosphere of constant growth and development for our employees.
Summit provides workers’ compensation programs and services to thousands of employers throughout the Southeast.
Summit is a member of Great American Insurance Group, a company that focuses on building relationships and linking people to various career paths. Whether it’s underwriting, claims, accounting, IT, legal, or customer service, Great American Insurance Group combines a small-company entrepreneurial atmosphere with big- company expertise.
Essential Job Functions and Responsibilities
- Audits medical charges to ensure appropriate reimbursement in accordance with state fee schedules or usual and customary guidelines.
- Determines relatedness, causality and appropriateness of treatment based on the compensable injury.
- Identifies potential fraudulent claims and assists adjusters with SIU (Special Investigation Unit) referrals.
- Handles telephone and written customer service inquiries.
- Makes claim referral decisions of a limited scope.
- Enters data into claim document files.
- Performs other duties as assigned.
- The person hired for this position will work out of the Lakeland, FL office which offers a hybrid work environment of 3 days in the office and 2 days work from home.
Job Requirements
Education: High school diploma or equivalent
Experience: 2 to 3 years of related experience.
Company:
SCI Summit Consulting, LLCBenefits:
We offer competitive healthcare, retirement and paid time off benefits.
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