# Nurse Auditor - Medical Bill Review (Remote)

**Company:** [Rising Medical Solutions](http://jobs.workable.com/companies/j3kmQn6YEVfPYKu97uT4gv.md)
**Location:** Remote
**Workplace:** remote
**Employment type:** Full-time
**Department:** 3500 Technical Assurance

[Apply for this job](http://jobs.workable.com/view/0283a41a-6a46-4a04-8cac-1116b7a6d6fb)

## Description

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 industry.

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 occurrence.
-   Verify that charges are in accordance with the services ordered and authorized.
-   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.

## Requirements

-   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 procedures
-   3-5 years of clinical experience in acute care, surgery and/or orthopedic
-   Workers’ Compensation medical bill review experience a major plus
-   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 skills
-   Experience in any deposition or litigation cases a plus

## Benefits

-   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 within!
-   Opportunity to make a difference in reducing health care costs and increasing the value of health care to individuals and their employers.
-   A relaxed, yet upbeat work environment
-   And for those in the office: casual dress code with unlimited coffee!