Medata is always looking for people to become a part of our team who are enthusiastic, motivated, and willing to learn. If there are no openings listed, please feel free to send us your resume.

Forward to humanresources@medata.com.

Bill Review Specialist

Under moderate supervision, this position is responsible for processing and auditing complex and/or high level medical bills in accordance with state Workers’ Compensation fee schedules rules and regulations, UCR, correct coding rules and PPO application/interface through the use of the Medata software. Bills will be processed in accordance with state mandated timeframes, client contractual requirements and established department production standards.

Duties / Responsibilities

  • Enter and review workers compensation or no fault medical bills into the Medata system
  • Analysis and review of 1 or more assigned states
  • Perform technical or specialty review in one or more of the following areas:
    • Complex Hospital, Surgery, Levels of Service, IME’s, etc
    • Reconsideration Requests
    • Quality Assurance Reviews
  • Select proper PPO network based on client instructions
  • Add or update Provider and Claim information as appropriate
  • Utilize Fee Schedules, Online Documents, Client instructions and other training material to proper review medical bills
  • Research usual and customary/fee schedule applications and system interface as appropriate
  • Provide quality review on work as specified by Lead/Supervisor
  • Perform quality assurance audits to ensure reviews are accurate
  • Proactively identify system and/or bill review issues and provide feedback to supervisors or manager
  • Other duties as determined by the Management

Requirements

  • High School diploma or equivalent – Associates Degree preferred.
  • Ability to review higher complexity bills for facility and/or professional services.
  • Knowledge for Worker’s Comp rules, regulations, and UCR and fee schedule rates.
  • Ability to properly address provider requests to reconsider allowances
  • Quality Review and  PPO Network experience a plus
  • Extensive knowledge of Workers’ Compensation medical fee schedules ( multi-state preferred ), state specific regulations, Medicare guidelines, ICD-9, CPT and HCPCs codes
  • Proficiency with 10-key pad at 9000+ kph or equivalent bill processing rate
  • Ability to work in a high production environment while meeting productivity and quality standards
  • Proficiency with Microsoft Word and Excel
  • Strong knowledge of Medical Terminology and CPT / ICD-9 coding
  • Effective written and verbal communication skills

Bill Review Analyst I and II

Under supervision, this position is responsible for analyzing incoming medical bills for fee schedule, no-fault or usual and customary application while meeting contractual client requirements. Candidate will be responsible for meeting production standards and level of accuracy on a daily basis as determined company standards and Management. Pay rate is commensurate with experience.

Duties / Responsibilities

  • Enter and or audit workers compensation or no fault medical bills into the Medata system
  • Analyze medical data (Claim, Payee, Provider, etc…) on medical billing forms to ensure accurate results within the Medata system
  • Proactively identify system and/or bill review issues and provide feedback to your lead or supervisor
  • Add or edit Provider and Claim information as appropriate
  • Utilize Client instructions and other training material to properly review medical bills
  • Other duties as assigned

Requirements

  • High School diploma or equivalent
  • Proficiency as a Bill Review Analyst 1 with 1 or more years experience in medical bill review (workers’ compensation is a plus) or related experience
  • Proficiency with 10-key pad at 9000+ kph or equivalent bill processing rate
  • Ability to work in a high production environment while meeting productivity and quality standards
  • Ability to learn new computer programs and software
  • Ability to work 40 hours per week
  • Proficiency with Microsoft Word and Excel

Preferences

  • Experienced Medical Bill Reviewer Designation
  • Strong written and verbal communication skills

Product Support Analyst II

A Product Support Analyst acts as a software expert and escalation point for Medata, Inc. products and services. The Product Support Analyst works with internal and external customers, IT, and developers to deliver complete resolutions, in a timely manner, and consistently, to address technical questions and concerns with configuration and use of our proprietary products.

Duties / Responsibilities

  • Develop expert level knowledge of company software products offered.
  • Provide high level support to all user types.
  • Analyze system issues and provide resolutions.
  • Evaluate, recommend and implement improvements to client environments.
  • Assess client business requirements and recommend best practices.
  • Create technical documents to define instructions and enhancements to software.
  • Maintain help library.
  • Document customer information and recurring issues to support product quality programs and product development.
  • Document issues in company software and triage incoming calls and emails.
  • Resolve or escalate the issue to the appropriate level Support analysts.
  • Troubleshoot incoming software issues by researching, reproducing the issue, and interfacing with customers, vendors and internal resources through resolution.

Requirements

  • Knowledge of workers’ compensation medical fee schedules including, applicable laws and regulations a plus.
  • 2+ years of industry experience desired.
  • Basic understanding of the Insurance Property and Casualty Industry helpful.
  • Proficiency in all Microsoft Office products with a heavy emphasis on MySQL.
  • Experience with Electronic Data Interfaces or as a Technical Support Representative.
  • Experience working with large data files.
  • Excellent organizational, analytical and problem solving skills.
  • Ability to provide clear written and verbal communication with both internal and external customers.
  • Ability to work independently, meet deadlines and be proactive.
  • Ability to work with minimal direct supervision.
  • Ability to provide activity reports in a timely manner.

Product Support Analyst I

A Product Support Analyst acts as a software expert and escalation point for Medata, Inc. products and services. The Product Support Analyst works with internal and external customers, IT, and developers to deliver complete resolutions, in a timely manner, and consistently, to address technical questions and concerns with configuration and use of our proprietary products.

Duties / Responsibilities

  • Develop expert level knowledge of company software products offered.
  • Provide high level support to all user types.
  • Analyze system issues and provide resolutions.
  • Evaluate, recommend and implement improvements to client environments.
  • Assess client business requirements and recommend best practices.
  • Create technical documents to define instructions and enhancements to software.
  • Maintain help library.
  • Document customer information and recurring issues to support product quality programs and product development.
  • Document issues in company software and triage incoming calls and emails.
  • Resolve or escalate the issue to the appropriate level Support analysts.
  • Troubleshoot incoming software issues by researching, reproducing the issue, and interfacing with customers, vendors and internal resources through resolution.

Requirements

  • Experience with Electronic Data Interfaces or as a Technical Support Representative.
  • Proficiency in all Microsoft Office products with a heavy emphasis on MySQL.
  • Knowledge of workers’ compensation medical fee schedules including, applicable laws and regulations a plus.
  • 2+ years of industry experience desired.
  • Basic understanding of the Insurance Property and Casualty Industry helpful.
  • Excellent organizational, analytical and problem solving skills.
  • Ability to provide clear written and verbal communication with both internal and external customers.
  • Experience working with large data files.
  • Ability to work independently, meet deadlines and be proactive.
  • Ability to work with minimal direct supervision.

Business Systems Analyst

The Business Systems Analyst is responsible for gathering requirements, performing technical analysis, developing product/project documentation, providing customer support by troubleshooting issues and translating them into software requirements for workers’ compensation/bill review.

Duties / Responsibilities

  • Participates in the design and enhancement of software products and business processes
  • Prepare Business Requirements Functional Specifications/Documentation to be shared with stakeholders, development and technical teams
  • Assesses project and/or business needs and produces supporting data and impact reports
  • Researches, reviews, and analyzes the effectiveness and efficiency of existing software features and develops strategies for enhancing or further leveraging the features
  • Prepares recommendations or alternatives for improving software features
  • Owns tasks and software project through full system development life cycle
  • Prepares UAT test cases and coordinates UAT with business stakeholders

Requirements

  • Experience and knowledge of EDI ANSI X12 (specific to chapters relevant to Billing/Medical/Insurance industry)
  • Experience with SQL query creation
  • Experience with Microsoft Office products
  • Skill in analytical and problem-solving techniques
  • Ability to demonstrate consistent precision and accuracy
  • Ability to interact effectively with various stakeholders, customers and vendors
  • Ability to understand how report results effect business decisions
  • Ability to continuously provide a high level of quality while working at high-paced velocity

Preferences

  • College degree from an accredited university (preferred) with an emphasis in mathematics 2-5 years experience required
  • Excellent customer service skills
  • Experience working in a team-oriented, collaborative environment
  • Must be self-motivated as well as creative and efficient
  • Detail-oriented
  • Proven analytical and problem-solving skills
  • Excellent time management skills
  • Effective interpersonal, communication, and organizational skills

Java Developer

Attention Java developers, we're looking for sharp software people to join our team. If you're smart, love programming, and know what you're talking about you'll fit right in. Send your resume and sample code. More code = extra points. We operate in an open source environment; therefore, your Linux skills and knowledge of Tomcat is needed.

Duties / Responsibilities

  • Design, prototype, develop, unit test, debug, and refactor enterprise web applications.
  • The developer will work closely with other web developers, QA, product management, and the deploy team; therefore, communication is important.

Requirements

  • You speak Linux
  • You have 4+ years experience with Java, JSP, Javascript, XML, HTML, CSS
  • You have 3+ years experience with SQL, preferably MySQL
  • You know Tomcat
  • You have a fundamental understanding and experience in designing application architectures. A solid understanding of implementing OO design patterns, such as MVC and are familiar with SOA principles.
  • You are a responsible, mature, and a highly motivated/self directed developer.
  • You work well in a team, and can work singularly or not based on the scope of a task.
  • A/BS Degree in Computer Science, Math, Engineering, or related field (In lieu of degree, 4 years relevant work experience) is preferred.

Permanent full time position with Medical/Dental/Vision/Life and 401K benefits. We are an Equal Opportunity Employer.

Account Coordinator

The Account Coordinator will provide both administrative and resourceful support to the Account Manager for a number of bill review service or software license accounts. Account Coordinators are responsible for “coordinating” new or existing accounts and provide client satisfaction. Coordinators speak with clients regularly, providing them product updates, technical support and other account-related reports. They are also responsible for list building, media tracking, and assisting with maintaining and nurturing the relationship with our clients. This position will be required to interact with varying levels of the client’s team.

Duties / Responsibilities

  • Assists Account Manager
  • Assists in strategy development
  • Assists with coordinating new ways to build the client’s business and grow accounts
  • Maintains vast knowledge of the Property and Casualty insurance industry as well as client’s business, competition, and latest industry news and trends

Requirements

  • Bachelor’s degree, 2+ years experience as an Account Coordinator, Client Support, and/or Customer Service
  • Operational understanding of Medical Bill Review and Workers’ Compensation industry (Auto Liability a plus)
  • Effective customer service skills
  • Extremely organized, highly motivated and able to multi-task
  • Excellent verbal/written communication skills
  • A positive attitude and ability to work under deadlines
  • Ability to think analytically and independently
  • Experience with new client implementations is not required but is a definite plus
  • A general understanding of programming specifications, electronic data interface (EDI) standards and database management optimization is not required but is a definite plus

Bill Review Trainee-Mailroom Clerk

Under moderate supervision, this position is responsible for all support tasks in Service Bureau including but not limited to incoming basic bill keying, mailing, batching, printing EORs, matching/attaching, sorting and sending outgoing mail. This position requires proper operation of computers (hardware and software), while maintaining an acceptable speed and level of accuracy determined by company standards and bill review manager. This position will be monitored daily, weekly and monthly for speed, accuracy and adherence to attendance policies.

Duties / Responsibilities

  • Data enter (Key from Image) simple medical bills under the direction of experienced processors or Team Lead.
  • Receive, sort and distribute incoming mail and faxes.
  • Date stamp incoming bills to be processed by bill review team.
  • Batch bills based on specific client instructions and enter data into system.
  • Prepare physical bills for processing according to client instructions.
  • Print completed reviews and run client process reports as appropriate.
  • Dispatch outgoing mail, weighing, addressing, stamping and sealing as needed, and verifies the proper date and amount on the postage meter.
  • Copy and fax office documentation, training materials, and department manuals.
  • Other duties as assigned.

Requirements

  • High School diploma or equivalent.
  • Accurate typing skills and 10-key by touch.
  • Working knowledge of Microsoft WORD and Excel.
  • Minimum one year experience and/or training in an office environment.
  • Must have the ability to read and comprehend simple instructions, short correspondence and memos, as well as ability to sort alphabetically or other basic system.
  • Strong attention to detail.
  • Prior mailroom experience helpful.
  • We offer a full benefits package including: Medical, Dental, Vision, Life Ins, 401k (with partial matching) and a Cafeteria Plan.

Systems Administrator

Orange County software provider is looking to add an experienced Systems Administrator to the team. We provide software, services, and hosted applications as part of our overall business model in a fast-paced and *growing* environment. We're looking for candidates who are equally at home supporting Workstations, Windows and Linux Servers, as well as network switches and patches. The primary focus of this position will be the direct support of in-house and colocated systems which support our core business, however will include a variety of day-to-day Tech support, workstation maintenance, system replacement and upgrade tasks. Other special projects related to the ongoing enhancement of our software products and services.

Duties / Responsibilities

Requirements

  • At least 2, preferably 5+ years experience troubleshooting computer and network related problems.
  • Solid understanding of Windows and Linux operating systems, common commands, and administrative tasks.
  • Experience with many of the technologies outlined above.
  • A strong desire to learn new technologies and products.
  • Strong verbal and written communication skills.
  • Ability to work with a team.
  • Ability to independently research and find solutions to problems.
  • Ability to help users over the phone.
  • Available to work nights and weekends as needed.
  • Excellent attention to detail.
  • Applicable industry certifications are preferred but not required.

Key technologies used within the business include:

  • Windows XP, Windows Vista, Windows 7 Workstations
  • MS Office 2003 / 2007
  • Asterisk / Trixbox VOIP PBX
  • Dell, HP, Supermicro, and white-box servers
  • Windows 2003 Server
  • CentOS 5.x / RHEL 5.x
  • Apache Tomcat, Apache HTTPd, and NGinx
  • MySQL, Postgre, and NoSQL database platforms
  • VMWare ESX and ESXi 3.x / 4.x virtualization platforms
  • SMB, NFS, and iSCSI
  • Cacti, Nagios, and Icinga monitoring platforms
  • SSH, HTTP, HTTPS, SFTP, FTPS, and SSL VPN communication
  • Cisco ASA, Linux IPTables, and BSD PF Firewalls
  • Cisco and Dell Switches

If you're interested and meet the minimum requirements outlined above, please email your resume, compensation history, as well as a cover letter including why you are the best qualified person for the job.

Specialty Review Analyst/Fee Negotiator

Under moderate supervision, this position is responsible for negotiating and auditing complex and high dollar medical and hospital claims.  Position requires communicating directly with medical providers to obtain negotiated agreement for assigned claims on behalf of employers and payers.  Bills will need to be negotiated in accordance with state workers compensation fee schedule rules and regulations, along with usual and customary / fair and reasonable payment policies. 

Duties / Responsibilities

  • Contact medical provider to obtain negotiated discount / savings on hospital, medical, and ancillary claims.
  • Processing of completed negotiated reviews through proprietary software application.
  • Perform clinical review and analysis of medical claims as part of negotiation process.
  • Utilize Fee Schedules, Online Documents, and Client Instructions along with other training material to properly review and negotiate medical claims.
  • Research healthcare payment policies such as Medicare, Medicaid, or Usual and Customary data sources to determine appropriate reimbursement to be used in negotiation process.
  • Perform follow-up and tracking of all assigned claims for review.
  • Perform quality assurance audits to ensure reviews are accurate.
  • Provide a summary and analysis report of medical costs for certain provider and hospital bills related to a specific claim file.
  • Other duties as assigned.
  • Reports to the Client Services Manager, providing regular input on all account activity, including status and call reports on a weekly basis.
  • Interacts directly with the Executive Management team.
  • Other tasks may be assigned based upon business needs.

Requirements

  • High School diploma or equivalent.
  • Proficiency as a medical / hospital billing analyst with three or more years of experience in bill negotiation and specialty bill audit.
  • Knowledge of medical billing guidelines including medical terminology, CPT, HCPCS, ICD-9 coding along with UB Revenue Code and MS-DRG classifications.
  • Extensive understanding of healthcare reimbursement and payment policies such as state mandated workers compensation and Medicare fee schedules; group health or commercial payer contracts; and usual and customary data sets.
  • Familiarity with general billing and coding practices for physician and hospital claims.
  • Proficiency with 10-key pad and typing.
  • Ability to work in a high production environment while meeting productivity and quality standards.
  • Proficiency with Microsoft Word and Excel.
  • Strong written and verbal communication skills.

Preferences

  • Experience with bill negotiation of workers compensation medical claims
  • Understanding of clinical review and line audit of hospital bills
  • Experience with hospital billing and collections