• Oversee day-to-day operations of the Bill Review unit focused on workers’ compensation medical claims.
• Act as the primary point of contact for client escalations related to workers' compensation bill review services.
• Ensure the team consistently meets key performance indicators (KPIs), including compliance with state-specific workers’ compensation regulations, quality standards, and turnaround times.
• Conduct quality assurance (QA) reviews of workers’ compensation claims to ensure accurate application of fee schedules and medical guidelines.
• Deliver regular coaching, feedback, and performance evaluations to promote staff development and maintain operational excellence.
• Lead hiring, training, and development efforts with a focus on regulatory compliance and industry-specific best practices.
• Identify inefficiencies or gaps in workflows, especially those affecting compliance or claim outcomes, and implement continuous process improvements.
• Provide technical guidance and subject-matter expertise in workers’ compensation billing, coding, and regulatory trends.
• Manage team workload distribution and approve operational expenses including overtime and reporting metrics.

• Bachelor’s degree in a healthcare-related field
• Minimum of 5 years in medical bill review operations, with at least 2 years in a management or supervisory role.
• Proven experience in workers’ compensation medical billing, coding, and compliance.
• Strong working knowledge of state-specific workers’ compensation regulations and fee schedules.
• Demonstrated ability to lead, motivate, and develop a high-performing team.
• Strong problem-solving skills and attention to detail.
• Excellent interpersonal and communication skills.

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All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity, sexual orientation, national origin, ethnicity, age, disability, marital status, or any other characteristic protected by law.

Genfinity as an Equal Opportunity Employer, believes in each person’s potential, and we’ll help you achieve yours.

All information will be kept confidential according to EEO guidelines.

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