Nurse Auditor - Medical Bill Review - Remote | WFH Job at Get It Recruit - Healthcare, Chicago, IL

S2EvbEhLWU9tUytKbTBqMElzWXlKakNNY2c9PQ==
  • Get It Recruit - Healthcare
  • Chicago, IL

Job Description

Have you ever glanced at a medical bill and noticed something wasn't quite right? Do you have the expertise and passion to make it right? If so, we want you on our team! We're seeking a dedicated Nurse Auditor who is eager to contribute to medical cost containment while ensuring clients receive exceptional service.

What You'll Do:

As a Nurse Auditor, you'll play a vital role in maximizing client savings by reviewing medical bills through a clinical lens. Your expertise will help ensure billing, coding, and treatment are appropriate, compliant with fee schedules, and free from errors. You'll be an essential part of our mission, providing clients with valuable insights based on your evaluations of medical records and billing statements.

Your responsibilities will include:

Auditing medical and billing records to assess the reasonableness, appropriateness, and necessity of services provided.
Identifying and evaluating any charges unrelated to the occurrence.
Verifying that charges align with the services ordered and authorized.
Initiating necessary communications with clients and medical providers.
Meeting productivity and turnaround time requirements consistently.
Adhering to quality standards, state billing guidelines, and HIPAA regulations to maintain confidentiality.
Negotiating bills and conducting re-evaluations as needed.
Serving as a resource for co-workers and demonstrating cultural sensitivity in diverse situations.
Continuously improving your skills and knowledge of our products and services through ongoing training and research.
Following established report formats and documentation guidelines.
Performing additional administrative tasks as requested.
This part-time position offers 20-24 hours of work each week, allowing you to balance your professional and personal life effectively.

What We're Looking For:

An active RN (or LPN) license or equivalent in our operational states.
CPC and/or CPC-H certification(s) are strongly preferred.
Specialized training in hospital coding, orthopedics, neurology, rehabilitation, or emergency procedures.
3-5 years of clinical experience in acute care, surgery, and/or orthopedics.
Experience with Workers' Compensation medical bill review is a significant advantage.
A solid understanding of CPT and ICD-10 codes, as well as Medicare guidelines.
The ability to apply knowledge to state fee schedules.
Strong communication skills and a customer service-oriented mindset.
Experience in depositions or litigation cases is a plus.
What We Offer:

A fully remote position.
Employment with a company dedicated to core values, staff development, and the integration of emerging technology. We believe in promoting from within!
The chance to make a real difference by helping reduce healthcare costs and increasing value for individuals and their employers.
A relaxed yet dynamic work environment.
Participation in our Elevate program, which recognizes and rewards employees for their hard work and dedication.
If you're ready to make a positive impact in the world of medical cost containment, we'd love to hear from you!
Employment Type: Full-Time
Salary: $ 34.00 Per Hour

Job Tags

Hourly pay, Full time, Part time,

Similar Jobs

Continuum Medical Staffing

Rheumatology - Physician Opportunity only Job at Continuum Medical Staffing

(Physician/MD qualifications required) Rheumatology - Rheumatology in Northeast, TN A well-established, very busy private practice in Kingsport, TN seeks to add a new board certified|eligible Rheumatologist. The current practice consists of two physicians and five... 

Prioxtel Virtual Solutions

Work-from-Home Pledge Drive Agent Job at Prioxtel Virtual Solutions

 ...Become a Pledge Drive Agent Are you enthusiastic about supporting great causes and speaking with people? Join us as a Work-...  ...school diploma or equivalent. Experience: 6 months remote or 1 year in a similar role. Strong communication skills... 

Tradition Chevrolet GMC of Newark

Automotive Parts Manager Job at Tradition Chevrolet GMC of Newark

 ...Tradition Ford in Newark is seeking an Automotive Parts Manager! DO YOU KNOW AUTO PARTS? DO YOU LOVE THE AUTOMOTIVE INDUSTRY BUT LONG FOR A BETTER WORK/LIFE BALANCE? THIS POSITION MAY BE WHAT YOU'VE BEEN SEARCHING FOR! NO LATE NIGHTS, NO SUNDAYS! Our Parts Manager... 

The Judge Group

Data scientist Job at The Judge Group

 ...Location: Pittsburgh, PA Description Role Data Scientist Type : Contractual ( No Sub Vendor) Location Dallas, TX or Pittsburgh, PA or Birmingham, AL or Phoenix AZ or Strongsville, OH Work Type Hybrid Roles And Responsibilities Establish... 

Frothy Monkey

Dishwasher - 12South Job at Frothy Monkey

 ...incredible food and drinks but also becoming an integral part of the communities we serve. Since 2004, Frothy Monkey has been a beloved staple in the Nashville community, earning accolades such as "Best Coffee Shop" and more in numerous publicationsthanks to the support of...