Bill reviewers are responsible for approving or denying medical billing claims. They do so after first checking for errors in medical coding or inconsistencies in a patient’s diagnosis and what they are being billed for. If a bill reviewer notices an issue within a billing statement, they may either perform a correction, request further information from a physician or third-party provider, or deny the claim altogether.
A bill reviewer’s job is important because it prevents patients from over or underpaying on services and it promotes better patient care by identifying and addressing issues in medical reporting.
- Evaluate medical bills, checking claim consistency and accuracy
- Analyze coding for errors and deny incorrect claims
- Edit and correct incorrect billing statements
- Create Explanation of Benefits (EOB) statements
- Administer billing citations
Qualifications and Skills
- High school diploma, GED, or equivalent experience
- Associate degree in a related field preferred
- 2+ years of medical billing/reviewing experience preferred
- Proficiency with word processing software