Remote Nurse Auditor - Medical Billing Review | WFH

Job Overview

Join our esteemed team as a Nurse Auditor specializing in Medical Bill Review, where your expertise will play a pivotal role in enhancing medical cost containment. This remote, part-time position offers you the opportunity to leverage your clinical insights to drive significant savings for clients while enjoying a flexible work environment.

Key Responsibilities

• Conduct thorough audits of medical and billing records to assess the reasonableness and necessity of services rendered.
• Identify and evaluate any charges that are unrelated to specific case occurrences.
• Verify that all charges are in accordance with the services that were ordered and authorized.
• Foster effective communication with both clients and medical service providers as necessary.
• Maintain productivity standards by consistently meeting turnaround time requirements.
• Comply with quality benchmarks, state billing guidelines, and HIPAA regulations, ensuring confidentiality of all information.
• Engage in bill negotiations and re-evaluations as required.
• Act as a knowledgeable resource to colleagues.
• Exhibit cultural sensitivity in all interactions.
• Commit to continuous skill enhancement through ongoing training and self-directed research.
• Follow established report formats and documentation standards.
• Provide administrative support as requested.
  
  

Required Skills

• A valid RN (or LPN) license or equivalent in states of operation.
• Highly desired CPC and/or CPC-H certification(s).
• Specialized training in hospital coding, orthopedic, neuro, rehabilitation, or ER procedures.
• Proficient understanding of CPT and ICD-10 codes, along with Medicare guidelines.
• Strong customer service orientation complemented by excellent communication skills.
• Experience with Workers' Compensation medical bill reviews is a considerable advantage.
• Familiarity with applying knowledge to state fee schedules.
• Experience related to deposition or litigation cases is an added plus.
  
  

Qualifications

• A minimum of 3-5 years of clinical experience in acute care, surgery, and/or orthopedics is essential.
  
  

Career Growth Opportunities

At our company, we are deeply committed to the professional growth of our staff. We emphasize core values and innovation, believing in the potential of our team members and providing ample opportunities for internal advancement and ongoing improvement.

Company Culture And Values

We pride ourselves on delivering exceptional customer service and maintaining a stellar reputation within the industry. Our work environment is characterized as relaxed yet dynamic, recognizing the dedication of our employees through various acknowledgment programs.

Compensation And Benefits

• This part-time role offers 20-24 hours per week, along with competitive compensation commensurate with experience.
• Enjoy the flexibility of remote work, allowing for a better work-life balance.
• Engage in meaningful work that contributes to reducing healthcare costs and improving care value for individuals and businesses alike.
• Participate in recognition initiatives designed to celebrate your hard work and commitment.
  
  

If you are eager to make a meaningful impact within the healthcare industry and advance your career alongside a dedicated team, we invite you to apply.

Employment Type: Full-Time