We are looking for experienced IBR Reviewers with hands-on experience in denial coding, hospital billing, and UB-04 forms. Candidates should have a strong understanding of healthcare claims, medical coding, payer policies, and reimbursement processes. Candidates with a nursing background are preferred/required.
Key Responsibilities
- Review hospital itemized bills to identify billing, coding, and reimbursement errors.
- Analyze healthcare claims and identify discrepancies in hospital billing.
- Handle denial coding and understand payer-specific policies and reimbursement guidelines.
- Review and validate UB-04 forms and supporting medical billing documentation.
- Calculate and verify claim review findings accurately.
- Document review findings and upload supporting information clearly.
- Monitor claim status,
turnaround time, and client-specific requirements.
- Maintain productivity and quality standards.
- Stay updated on medical coding guidelines, AHA Coding Clinic updates, and payer policies.
- Ensure compliance with data privacy and confidentiality standards.
Required Skills
- 3–6 years of relevant experience in denial coding, hospital billing, or IBR review.
- Hands-on experience with UB-04 forms and hospital billing processes.
- Robust knowledge of healthcare claims, billing, coding, and denial resolution.
- Understanding of payer policies and reimbursement guidelines.
- Nursing background preferred/required.
- CPC certification is an added advantage.
- Good analytical, documentation, and communication skills.