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Bill Review Nurse

$77k-109k/hr•Full-timeRemote

location_onEast Walnut Street, Lakeland, Polk County, Florida, 33801, United States

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Job Description

About the Role

As a Bill Review Nurse, you will serve as a subject matter expert within the organization, providing professional advice and expertise to Claims staff in developing and providing medical and cost control procedures. You will also provide technical advice to lower-level associates and other functional areas. This role is designed for an experienced Registered Nurse with a deep understanding of managed care laws and regulations. You will play a key part in ensuring the appropriateness of bills and identifying potential system or procedural improvements.

Work location

Work model: Remote

East Walnut Street, Lakeland, Polk County, Florida, 33801, United States

Lakeland, Florida

Open in Google Maps(28.03967, -81.94982)

Key Responsibilities

  • check_circleNegotiate pre-surgical services
  • check_circlePerform audits to identify potential leakage and procedural improvements
  • check_circleProvide medical and cost control advice to claims staff
  • check_circleReview facility and professional bills against medical records and agreements for appropriateness
  • check_circleCoach staff and participate in talent selection and performance management
  • check_circleOffer technical guidance to lower-level associates and other functional areas

Requirements

  • verifiedBachelor’s degree in Healthcare Management, Nursing, or a related field
  • verifiedR.N. (Registered Nurse) required
  • verified14 years of case
  • verifiedExpert knowledge of managed care laws and regulations.
  • verifiedAdvanced ability to identify and address nuanced details.
  • verifiedDemonstrated expert proficiency in.
  • verifiedExcellent interpersonal and.
  • verifiedStays informed about.
  • verifiedProven ability to.
  • verifiedAdvanced analytical skills with.
  • verifiedRecognized as a subject.

Benefits & Perks

check_circleMedical, dental, and vision coveragecheck_circleWellness planscheck_circleParental leavecheck_circleAdoption assistancecheck_circleTuition reimbursementcheck_circlePaid Time Off and paid holidayscheck_circle401(k) plan with company matchcheck_circleEmployee stock purchase plancheck_circleCommuter benefits

Skills, education and keywords

Skills: case management, managed care, healthcare management, nursing, medical records, claims, audits, 401(k).

Education: Bachelor’s degree in Healthcare Management, Nursing, or a related field..

Frequently asked questions about Bill Review Nurse at Summit Consulting

What does a Bill Review Nurse at Summit Consulting do?expand_more
Day-to-day, the Bill Review Nurse at Summit Consulting will negotiate pre-surgical services; perform audits to identify potential leakage and procedural improvements; provide medical and cost control advice to claims staff; and review facility and professional bills against medical records and agreements for appropriateness.
What are the requirements for this Bill Review Nurse role?expand_more
To qualify for the Bill Review Nurse at Summit Consulting position, applicants should have: Bachelor’s degree in Healthcare Management, Nursing, or a related field; R.N. (Registered Nurse) required; 14 years of case; Expert knowledge of managed care laws and regulations.; Advanced ability to identify and address nuanced details.; and Demonstrated expert proficiency in..
What is the salary range for Bill Review Nurse at Summit Consulting?expand_more
The advertised salary range for Bill Review Nurse at Summit Consulting is $77k-109k/hr.
Where is the Bill Review Nurse role at Summit Consulting located?expand_more
Bill Review Nurse at Summit Consulting is based in East Walnut Street, Lakeland, Polk County, Florida, 33801, United States. This is a remote role.
Is this Bill Review Nurse job remote, hybrid, or on-site?expand_more
Summit Consulting has listed this Bill Review Nurse role as remote.
How much experience is required for this Bill Review Nurse role?expand_more
Bill Review Nurse at Summit Consulting typically requires 14+ years of relevant experience at the lead level.
What skills do you need for the Bill Review Nurse role at Summit Consulting?expand_more
Key skills for Bill Review Nurse at Summit Consulting include case management; managed care; healthcare management; nursing; medical records; claims; audits; and 401(k).
What education is required for Bill Review Nurse at Summit Consulting?expand_more
Educational requirements for this role: Bachelor’s degree in Healthcare Management, Nursing, or a related field..
What category does the Bill Review Nurse role belong to?expand_more
Bill Review Nurse at Summit Consulting is part of the Healthcare & Nursing job category on Recrutus.