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General information

Location
Remote
Function
RCM
Business Unit
Shared Services
Full-time/Part-time
Full Time
Salary Range (USD)
17.5-21.43
Country
United States
Date
07-Jan-2025
Job ID
4562

Description & Requirements

Join Our Team and Make a Difference! 

Are you looking for an impactful role where you finish the workday knowing you helped someone? Whether you're part of our care coordination team or playing a supporting role, the work our colleagues do every day enables us to collectively reach our mission of getting people the care they need when they need it.By staying committed to our core values of Think Big, Go Fast, Deliver Awe, and Win Together we can positively impact the lives of the injured workers we serve and get them back to the things that matter most in life.

Salary Range:

This compensation range considers a wide range of factors, including, but not limited to, skill set, experience and training, licensure and certifications, and other business and organizational needs. The disclosed range estimate is not adjusted for geographic differential associated with the location where the position may be filled. At One Call, it is not typical for an individual to be hired at or near the top of the range for their role, and compensation decisions are dependent on the facts and circumstances of each case.  

What We Provide in Return for Your Commitment to our Mission 
 We offer a vast array of benefits to help support the whole you, including:  

  • Remote Work:We are a remote-first company and almost all positions receive the flexibility of working from home. 
  • Generous Time Off:In addition to 8 company holidays and 2 floating holidays every year, all colleagues receive a minimum of 18 days of paid time off. 
  • Comprehensive Benefits Package:Including medical, dental, vision, and pet insurance; 401(k) matching program; and company-paid life insurance and short and long-term disability coverage.   
  • Supportive Services:Just like our colleagues get people the care they need when they need it, we want to do the same for our colleagues in their time of need. From a Colleague Assistance Program that offers free counseling and financial services to our One Call Foundation, a non-profit arm of our company that provides colleagues financial assistance during times of unexpected hardships.

JOB SUMMARY: 

The Retro Billing Associate reviews bills submitted by payors and channel partners via One Call’s retrospective program.  Associates follow state and federal guidelines fee schedules and customer-specific rules to obtain enhanced savings for our clients. Associates interact with Providers and Claim Professionals as necessary to deliver accurate and efficient bill processing. Communicates timely responses to inquiries from Internal and External customers.  

 

GENERAL DUTIES & RESPONSIBILITIES:  

• Learns or remains current on billing protocols and regulations federal and state regulations and internal procedures that affect processing 

• Provides subject matter expertise on billing and coding guidelines and regulations as required by the department 

• Uses internal and external billing protocols and regulations for repricing bills at a cost savings to the customer 

• Identifies trending opportunities related to policies and procedures to ensure efficiency and accuracy in bill processing 

• Reviews researches and initiates the resolution of billing errors 

• Reviews researches and resolves customer-related inquiries 

• Develops/maintains process documentation for each assigned task 

• Communicates with appropriate internal departments to solve issues and discrepancies 

• Performs other related duties as assigned 

 

EDUCATIONAL AND EXPERIENCE REQUIREMENTS: 

• High school diploma/GED required. 

 

GENERAL KNOWLEDGE SKILLS & ABILITIES: 

• Knowledge of Billing rules and regulations and federal and state regulations 

• Excellent customer service skills that build high levels of customer satisfaction 

• Effective verbal and written communication skills 

• Computer navigation and operation skills 

• Detail-oriented with good organizational skills 

• Ability to manage multiple tasks 

• Ability to work both independently and in a team environment 

• Ability to maintain confidentiality 

• Proficient with Microsoft Office 

 

PHYSICAL/EMOTIONAL DEMANDS & WORK ENVIRONMENT: 

• For roles located in office or home settings; this job is primarily sedentary and may involve repetitive motions. The employee is regularly required to sit use hands and fingers speak and hear. 

• The employee is occasionally required to stand walk and lift objects (up to 10 lbs. weight; up to 4 ft. height).  

• Specific vision abilities required by this job include ability to see things from a close distance and ability to adjust focus. 

• The in-office work environment utilizes florescent lighting; noise level is moderate. 

• The emotional demand of the job may cause undue stress from but not limited to regular weekly/bi-weekly/quarterly/year end deadlines and a moderate/heavy workload. 

• Reasonable accommodations will be individually assessed and possibly made to enable individuals with disabilities to perform the essential functions of the position.  

• Please be advised the job description is subject to change at any time. 

    

ADDITIONAL LEVELS WITHIN JOB FAMILY (IF APPLICABLE)   

Retro Billing Associate I 

Entry level role. Basic skills with moderate level of proficiency. Resolves routine questions and problems; refers more complex issues to higher levels. Consults with senior peers and team leads on non-complex issues to learn through experience. Works under close supervision without latitude for independent judgment. Follows standard procedures and written instructions to accomplish assigned tasks.  Requires a High School diploma and typically less than 1 year of experience in an office setting and/or billing experience. 

Retro Billing Associate II 

Intermediate role. Moderate skills with high level of proficiency. Performs billing resolution processing and handles inquiries. Questions and issues are predominantly routine but associate must be able to deviate from standard scripts and procedures as needed.  Assists with resolving billing related issues within the department. May coach and share information with associates with less experience and/or expertise. Works under close to general supervision with little latitude for independent judgment. May consult with senior peers and team leads to learn through experience. Requires a High School diploma and typically a minimum of 1 to 3 years of experience in an office setting and/or billing experience. 

Retro Billing Associate Senior 

Senior level role. Highly skilled with extensive proficiency. Applies moderate skills to job or specialization. May adapt procedures processes tools equipment and techniques to meet more complex requirements of job. Questions and issues are predominantly routine but associate must be able to deviate from standard scripts and procedures as needed.  May require advanced problem solving. Plays a lead role in escalations. Resolves billing-related issues within the department.  Assists and coaches less experienced employees with semi-complex to complex processes. Works under general supervision with some latitude for independent judgment. Requires a High School diploma and typically three or more years of bill review experience with at least two years in customer service and 1 year in workers compensation.  

 

 

We are an equal opportunity employer and all qualified applicants will receive consideration for employment regardless to race, color, religion, sex, nationality, disability status, protected veteran status, or any other status protected by law.