Homeoffice Bill Review Director at Ethos Risk Services

ABOUT US: Ethos Risk Services is a leading insurance claims investigation and medical management company committed to providing better data that translates into better decision-making for our clients. We are at the forefront of innovation in our space, and our success is driven by a dynamic team passionate about delivering exceptional services to our customers.

JOB SUMMARY: Our Ethos Medical Management Team is seeking a full-time Bill Review Director (REMOTE) to oversee the strategic and operational management of the Bill Review Division, including staff leadership, budgeting, workflow optimization, and client satisfaction. This role ensures compliance with state and national regulations while fostering an environment of accuracy, efficiency, and continuous improvement. The Director will also collaborate closely with Sales, Case Management, Utilization Review, IME, and Accounting teams to achieve organizational goals and maintain exceptional service standards.

Our ideal candidate is a solutions-driven leader who takes pride in developing teams that exceed performance goals. They have a strong command of Workers' Compensation billing processes and extensive experience managing large-scale bill review functions.

KEY RESPONSIBILITIES:

• Lead, mentor, and develop the Bill Review Operations team, including Operations Managers and staff.
• Oversee departmental operations, workflow, service delivery, and performance outcomes.
• Manage budgets, staffing, and resource allocation to support operational goals.
• Ensure adherence to all applicable regulations, state fee schedules, and company policies.
• Conduct meetings, interviews, performance reviews, orientations, and disciplinary actions as needed.
• Oversee referral intake, open case counts, and staff assignments to maintain workload balance.
• Develop and maintain Standard Operating Procedures (SOPs) for consistent service delivery.
• Partner with internal teams and clients to identify process improvements and drive efficiency.
• Deliver exceptional client service through stewardship meetings, timely reporting, and proactive communication.
• Prepare and present quarterly performance statistics for Executive Management.

QUALIFICATIONS:

Education: Associate degree or Bachelor's degree preferred.

Required Experience:

• Minimum of 10+ years of experience in Workers' Compensation bill processing or medical bill review.
• Proven leadership experience overseeing all aspects of a Bill Review Department.
• Strong knowledge of medical terminology, billing practices, and applicable fee schedules.

WORKING CONDITIONS:

This position is 100% remote, with required availability during standard business hours. This role requires a dedicated workspace with reliable internet. The role involves prolonged periods of sitting, operating a computer, and communicating via phone and email.

Ethos Risk Services is an equal opportunity employer that does not discriminate on the basis of religious creed, sex, national origin, race, veteran status, disability, age, marital status, color or sexual orientation or any other characteristic.