Job Description

Repricing Associate (Remote)

Job Summary

Seeking a detail-oriented and motivated Repricing Associate to join a team. In this role, you will be responsible for data entry of billing information, verification of ICD-10 and CPT-4 codes, and submission of reconsiderations. Reporting to the Workers’ Compensation Claims Manager, you will play a critical role in ensuring compliance with state laws and maintaining the accuracy of medical billing processes. This is a fully remote, temporary position expected to last through Q2 of 2027.

Compensation Package

• Hourly Rate: $24 - $29 per hour
• Employment Type: 6-month contract with potential for extension
• Work Arrangement: 100% remote, based anywhere in the United States

Final compensation will be determined based on candidate qualifications, geographic location, and other considerations permitted by law.

Responsibilities

• Perform data entry of billing and Medicare reporting while verifying ICD-10 and CPT-4 codes.
• Research, respond to, and track inquiries to ensure compliance with state laws.
• Handle Electronic Data Interchange (EDI) claim rejections and apply manual repricing as needed.
• Process and administer reconsiderations and appeals while collaborating with vendors and provider networks.
• Research issues related to provider returned checks and reimbursement inquiries, and process these requests.
• Participate in quarterly oversight calls/meetings with PPO Networks and vendors.
• Cross-train on all provider network tasks within the department.
• Prepare comprehensive reports with minimal guidance.
• Perform other duties as assigned.

Qualifications/Requirements

Knowledge, Skills & Abilities:

• Strong understanding of billing and coding procedures, including medical terminology.
• Ability to meet turnaround time standards and comply with state law requirements in the Medical Bill Repricing process.
• Proficiency in preparing detailed reports with minimal supervision.
• Strong verbal and written communication skills, attention to detail, and ability to multitask.
• Ability to navigate multiple systems and screens simultaneously.
• Self-motivated, flexible, and capable of working both independently and collaboratively in a virtual office environment.
• Strong customer service skills and ability to manage workload effectively to meet deadlines.
• Proficiency with MS Word, Excel, Outlook, Teams, Slack, Zoom, and internet applications.
• Reliable internet connection is required.

Education:

• College degree or college-level education preferred.

Experience:

• Experience in a medical billing environment is required.
• Familiarity with Medicare/CMS requirements.
• Coding accreditations are a bonus.

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