Bill Review Nurse
| Company | American Financial Group |
|---|---|
| Location | Lakeland, FL, USA |
| Salary | $Not Provided – $Not Provided |
| Type | Full-Time |
| Degrees | Bachelor’s |
| Experience Level | Junior, Mid Level |
Requirements
- Bachelor’s degree in Healthcare Management, Nursing, or a related field
- R.N. (Registered Nurse) required
- RN license required
- Experience and working knowledge of health insurance; Workers Compensation a plus
- CPC certification
- Understanding of hospital coding & bills rules
- Highly organized
- Analytical with ability to solve complicated multi-faceted problems
Responsibilities
- Reviews Facility and Professional bills as it compares with medical records, diagnosis & agreements for appropriateness or inconsistencies
- Negotiates Pre-Surgical Services
- Performs audits seeking potential leakage and/or system or procedural improvements
- Provides professional advice and expertise to Claims staff in developing and providing medical and cost control procedures
- Provides technical advice to lower-level associates and other functional areas
- Assists with special projects as needed
- May have responsibility for performance and coaching of staff and may have a participatory role in decisions regarding talent selection, development, and performance management for direct reports
- Performs other duties as assigned
Preferred Qualifications
-
No preferred qualifications provided.