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Bill Reviewer

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. 

Job Responsibilities

  • 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