This Medical Bill Review & Compliance Advisor (MBR) role is responsible for the management of the vendors related to the medical bill review process as well as PPO network performance results. Performs analysis of trends to identify appropriate solutions and responses to positively impact loss costs and expense savings. Ensures adherence to compliance regulations by monitoring and providing oversight to all rules and regulations. Provide operational consistency and integrity as well as continuous quality improvement and maximum performance. Serve as a technical expert with regards to workers compensation medical spend strategy focused on enterprise bill review processes.
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