Nurse Auditor - Medical Bill Review (REMOTE POSITION)
Company: Rising Medical Solutions
Posted on: May 16, 2022
Have you ever looked a medical bill and immediately noticed
something was wrong? Were you itching to use your expertise to fix
it? We've been there, too. In fact, that's how our business was
born - and continues to thrive. Rising Medical Solutions is looking
for a Nurse Auditor who wants to make their mark in the world of
medical cost containment.
Join our team and maximize client savings by reviewing medical
bills from a nurse perspective, including appropriate billing,
coding and treatment, fee schedule compliance, over-utilization,
and erroneous charges. We pride ourselves on outstanding customer
service and work hard to keep our impeccable reputation in the
In this role, you'll be a part of our mission by giving clients the
information they need to determine case value based on evaluation
of medical records and medical billing statements, and will
Audit medical and billing records to determine if services provided
are reasonable, appropriate and necessary.
Clinically identify and evaluate any charges not related to the
Verify that charges are in accordance with the services ordered and
Initiate appropriate contacts with clients and medical providers as
appropriate and necessary.
Negotiate bills and conduct re-evaluation reviews as required
All while maintaining a human touch, demonstrating sensitivity to
culturally-diverse people and situations.
RN (or LPN) with active professional license or equivalent within
states of operation
CPC and/or CPC-H certification(s) strongly desired
Specialized training in hospital coding, ortho, neuro, rehab, or ER
3-5 years of clinical experience in acute care, surgery and/or
Workers' Compensation medical bill review experience a major
Understanding of CPT and ICD-10 codes and Medicare guidelines
Ability to apply knowledge to state fee schedules
A customer service orientation, including strong communication
Experience in any deposition or litigation cases a plus
Competitive benefits package, including health insurance, 401(k)
with company match, paid time off, paid holidays, and more.
Flexible hybrid schedule with in-office days reserved for training
and collaborative meetings
Employment within a firm committed to core values, staff
development, emerging technology, private ownership, and controlled
growth/reinvestment in the future - we frequently promote from
Opportunity to make a difference in reducing health care costs and
increasing the value of health care to individuals and their
A relaxed, yet upbeat work environment
And for those in the office: casual dress code with unlimited
Keywords: Rising Medical Solutions, Boston , Nurse Auditor - Medical Bill Review (REMOTE POSITION), Accounting, Auditing , Boston, Massachusetts
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