Job Description

Have you ever reviewed a medical bill and instantly spotted something that didn't seem right? Do you feel a strong urge to put your expertise to work and make corrections? If so, you're not alone—many of us feel the same way. That's exactly how our company began, and it's how we continue to thrive today.

We are looking for a passionate Nurse Auditor to join our team and contribute to medical cost containment. In this role, you'll use your clinical knowledge to review medical bills for accuracy, proper coding, and compliance. You'll help our clients save money by identifying overcharges, ensuring fee schedule compliance, and addressing any billing errors.

What You'll Do:

Audit medical and billing records to ensure services provided are reasonable, necessary, and correctly billed.
Clinically evaluate any charges unrelated to the incident in question.
Verify that the services billed align with those ordered and authorized.
Collaborate with clients and medical providers as needed.
Consistently meet productivity goals and turn-around time requirements.
Follow state billing guidelines, quality standards, HIPAA regulations, and ensure confidentiality.
Conduct re-evaluation reviews and negotiate bills when necessary.
Act as a resource for your colleagues, providing support and guidance.
Show sensitivity to diverse cultures and situations in all interactions.
Continuously improve your knowledge of billing practices, medical codes, and industry updates through training and research.
Ensure all reports and documentation meet company standards.
What You Bring:

Active RN or LPN license (or equivalent) in relevant states.
CPC and/or CPC-H certification(s) highly preferred.
Specialized training in hospital coding, orthopedics, neuro, rehabilitation, or ER procedures.
3-5 years of clinical experience in acute care, surgery, and/or orthopedics.
Experience with Workers' Compensation medical bill review is a major plus.
Strong knowledge of CPT, ICD-10 codes, and Medicare guidelines.
Ability to interpret and apply state fee schedules.
Excellent communication skills with a focus on customer service.
Experience with deposition or litigation cases is a bonus.
Why Join Us?

Remote position with part-time hours (20-24 hours per week).
Be part of a team committed to professional development, emerging technology, and long-term growth.
Opportunity to make a meaningful impact by helping reduce healthcare costs while improving the value of care.
Relaxed, supportive, and positive work environment.
Access to our Elevate program, designed to recognize and reward your hard work.
Employment Type: Full-Time
Salary: $ 34.00 Per Hour

Job Tags

Hourly pay, Full time, Part time,

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