Job ID: 1789833
Reference Code: CoreyFee-Schedule Specialist6-4
Job Summary
We are seeking a detail-oriented Fee Schedule Specialist for a contract-to-hire opportunity in Grand Island, NY. This hybrid role is ideal for a medical billing, coding, or payer-side bill review professional who enjoys analytical work, regulatory accuracy, and resolving complex reimbursement questions.
The Fee Schedule Specialist will review and process medical bills related to New York State Workers’ Compensation and Auto/No-Fault claims. This position offers a stable Monday through Friday schedule, a supportive team environment, and the opportunity to work with experienced professionals in medical bill review, claims, and reimbursement operations. Candidates can expect a collaborative workplace with strong leadership, clear expectations, and the potential for long-term career growth, including possible full-time remote flexibility.
Key Responsibilities
- Review medical bills, records, and supporting documentation for accuracy, compliance, and reimbursement determination.
- Apply NYS Workers’ Compensation and Auto/No-Fault fee schedules, Medicare methodologies, PPO contracts, and client-specific billing guidelines.
- Interpret CPT, HCPCS, ICD-10 codes, modifiers, and medical terminology to identify discrepancies and determine proper reimbursement.
- Process bills using platforms such as Strataware, Conduent, Medata, Mitchell, or similar bill review systems.
- Prepare accurate EOBs, C-8s, C-8.1s, and other required regulatory notices in accordance with applicable guidelines.
- Communicate professionally with adjusters, providers, clients, and internal teams to resolve billing, coding, or documentation issues.
Compensation and Benefits
- Pay: $50,000 to $65,000 per year.
- Job Type: Contract/Temporary, temp-to-perm after 720 hours.
- Schedule: Monday through Friday, 8:00 AM to 4:30 PM.
- Location: Grand Island, NY.
- Workplace Type: Hybrid with potential for full-time remote.
- 3% matching 401(k) with company contribution.
- PTO: 10 days plus 5 NYS sick days.
- Health and dental plans available.
Equal Opportunity Employer / Disabled / Protected Veterans
The Know Your Rights poster is available here:
https://www.eeoc.gov/sites/default/files/2023-06/22-088_EEOC_KnowYourRights6.12.pdf
The pay transparency policy is available here:
https://www.dol.gov/sites/dolgov/files/ofccp/pdf/pay-transp_%20English_formattedESQA508c.pdf
For temporary assignments lasting 13 weeks or longer, AppleOne is pleased to offer major medical, dental, vision, 401k and any statutory sick pay where required.
We are committed to working with and providing reasonable accommodations to individuals with disabilities. If you need a reasonable accommodation for any part of the employment process, please contact your staffing representative who will reach out to our HR team.
AppleOne participates in the E-Verify program in certain locations as required by law. Learn more about the E-Verify program.
https://e-verify.uscis.gov/web/media/resourcesContents/E-Verify_Participation_Poster_ES.pdf
We also consider for employment qualified applicants regardless of criminal histories, consistent with legal requirements, including, if applicable, the City of Los Angeles’ Fair Chance Initiative for Hiring Ordinance. Pursuant to applicable state and municipal Fair Chance Laws and Ordinances, we will consider for employment-qualified applicants with arrest and conviction records, including, if applicable, the San Francisco Fair Chance Ordinance. For Los Angeles, CA applicants: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.
Required Qualifications and Skills
- Review and analyze medical bills for NYS Workers’ Compensation and Auto/No-Fault claims.
- Apply fee schedules, Medicare methodologies, PPO contracts, and client-specific reimbursement rules.
- Identify billing discrepancies such as duplicate billing, unbundling, incorrect modifiers, excessive charges, and unsupported services.
- Maintain accurate documentation, meet turnaround standards, and support quality assurance and process improvement efforts.
- 1 to 2 years of medical billing, coding, or bill review experience preferred.
- Working knowledge of CPT, HCPCS, ICD-10, modifiers, medical terminology, and reimbursement methodologies.
- Familiarity with payer-side medical bill review operations and documentation requirements.
- Ability to review medical records and determine whether billed services are supported and compliant.
- Proficiency with Microsoft Office, including Excel and Outlook.
- Strong analytical, organizational, and problem-solving skills.
- Excellent written and verbal communication skills.
- Ability to work independently and collaboratively in a fast-paced environment.
- Ability to maintain a consistent full-time schedule Monday through Friday.
Preferred Qualifications
- CPC-A or CPB certification preferred.
- CPC or related coding credential is a plus.
- Knowledge of NYS Workers’ Compensation and/or Auto/No-Fault billing practices preferred.
- Experience with Strataware, Conduent, Medata, Mitchell, or similar bill review platforms preferred.
- Experience with NYS Workers’ Compensation or auto insurance claims is a plus.