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Medical Bill Review Supervisor (Working Supervisor & Legal Expert)

3 weeks, 2 days ago
United States
Full-time
Lead
Legal Counsel
Operations
Apply Now
Dane Street

Dane Street

Dane Street provides independent medical examination and peer review services tailored for the insurance industry, focusing on areas such as workers' compensation, disability, and auto liability, while emphasizing quality, compliance, and timely delive...

Insurance
251-1K
Founded 2008
View All Jobs 49

Description

  • Supervise, mentor, and audit bill review staff and contract experts to ensure accuracy, productivity, and turnaround times.
  • Directly review complex, high-dollar, and disputed medical bills as a working supervisor.
  • Perform quality control audits, identify training gaps, and update standard operating procedures.
  • Administer and optimize medical bill review software workflows, auto-adjudication rules, and engine logic.
  • Apply national repricing and payer guidelines to identify erroneous billing and overbilling.
  • Ensure correct application of fee schedules, line-item audits, CCI edits, and clinical validation rules across multiple lines of business.
  • Conduct forensic reviews of medical records, itemized bills, and payment ledgers for litigation cases.
  • Prepare expert reports and affidavits supporting billing accuracy, unbundling, upcoding, or phantom charges.
  • Provide deposition and trial testimony as an expert witness and explain coding systems in plain language.
  • Support Texas-specific regulatory alignment and fee schedule application, where applicable.

Requirements

  • 5–7 years of hands-on experience in medical bill review.
  • 2+ years of supervisory, team lead, or senior mentoring experience.
  • Proven experience providing legal services, expert witness reports, or trial testimony on medical bill reasonableness and UCR value analysis.
  • Advanced proficiency with bill review platforms such as Conduent/StrataCare, Mitchell/Enlyte, Medata, CompIQ, or similar.
  • Texas-based candidates are highly preferred, or candidates must have extensive experience testifying in Texas courts and applying Texas statutory fee schedules.
  • Active industry certification such as CPC or CCS is required.
  • Strong knowledge of healthcare fraud, waste, abuse, and systemic billing irregularities.
  • Ability to communicate professionally and remain composed under expert testimony pressure.
  • Strong time-management skills to balance team management, production queues, and deadlines.
  • Experience with CPT, ICD-10, HCPCS, DRG, workers' compensation guidelines, and UCR fee structures is preferred.

Benefits

  • Medical, dental, and vision coverage for employees and their families.
  • Voluntary life insurance options for employees, spouses, and children.
  • Additional voluntary benefits including hospital indemnity, critical illness, accident indemnity, and pet insurance.
  • Basic life insurance, short-term disability, and long-term disability coverage at no cost.
  • Generous paid time off.
  • 401(k) plan with company match.
  • Apple equipment and a media stipend for remote workspace.

Interested in this position?

Apply directly on the company website

Apply Now

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