Job Description

Nurse Auditor

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.

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