Job Description

<div>
 <p>
  <strong>
   Position Summary
  </strong>
 </p>
 <p>
  Responsible for auditing in-patient and/or surgical bills to promote excellence in medical bill review and process improvement.
 </p>
 <p>
  <br/>
 </p>
 <p>
  <strong>
   Responsibilities
  </strong>
 </p>
 <p>
  <br/>
 </p>
 <p>
  A.
  <strong>
   Medical Bill Review
  </strong>
 </p>
 <ul>
  <li>
   Processes inpatient and/or surgical bills by adhering to the given standard operating procedures (SOP) and turnaround time to complete the task
  </li>
  <li>
   Performs bill review process by utilizing appropriate resources
  </li>
  <li>
   Clarifies billing discrepancies to analyze and recommend appropriate reimbursement
  </li>
  <li>
   Documents pertinent information in the system bill notes to support reimbursement determination
  </li>
  <li>
   Performs reconsideration of bills, as per request, to ensure original bill processing determination is appropriate
  </li>
  <li>
   Collaborates objectively with peer physicians to facilitate determination of reimbursement
  </li>
 </ul>
 <p>
  <br/>
 </p>
 <p>
  B.
  <strong>
   Business Process Support
  </strong>
 </p>
 <ul>
  <li>
   Provides assistance to Business Process Associates and other concerned departments with regards to billing issues, inquiries on fee schedules and/or ground rules for a particular state
  </li>
  <li>
   Inform appropriate process owner regarding issues related to calculation of reimbursement
  </li>
  <li>
   Communicates effectively with persons involved in case management process as needed
  </li>
  <li>
   Liaise with company attorneys to assist in possible litigated claims
  </li>
  <li>
   Refers matters beyond limits of authority and expertise to immediate superior for direction
  </li>
  <li>
   Upholds the Crawford Code of Conduct by protecting the confidentiality of information
  </li>
  <li>
   Performs other related tasks as required or needed
  </li>
 </ul>
 <p>
  <br/>
 </p>
 <p>
  <strong>
   Requirements
  </strong>
 </p>
 <p>
  <br/>
 </p>
 <ul>
  <li>
   Bachelor&rsquo;s degree in Nursing
  </li>
  <li>
   Must be a Philippine Registered Nurse
  </li>
  <li>
   Minimum of (1) year of diverse clinical experience or prior experience in Medical Bill Review.
  </li>
  <li>
   Good communication skills
  </li>
  <li>
   Proficient in word processing software applications
  </li>
  <li>
   Maintains high degree of professionalism and confidentiality
  </li>
  <li>
   Ability to multi-task, prioritize and manage time effectively
  </li>
  <li>
   Interpersonal skills - Able to work independently and as a team member
  </li>
  <li>
   Keen attention to details
  </li>
 </ul>
 <p>
 </p>
</div>