Payor Dispute Nurse Reviewers

Michael Hill MD and Associates; United States; Remote; USD 100,000 - 125,000; Part time

Job summary

A leading healthcare consulting firm is seeking a Payor Dispute Nurse Reviewer for a part-time remote role. The position involves managing hospital payment disputes with insurance companies, requiring extensive experience in nursing and claims management. Ideal candidates will possess analytical skills and be detail-oriented, capable of working independently.

Qualifications

• 5-7 years of experience in case management, utilization management, or claim denial management.
• Experience with payer disputes and claims resolution.

Responsibilities

• Review hospital payment disputes with insurance companies.
• Ensure accurate reimbursement for provided services.

Skills

Nursing experience with medical record review and denial management

Knowledge of healthcare billing and revenue cycle management

Strong analytical and problem-solving skills

Detail-oriented and able to work independently

Experience in payer disputes and claims resolution

Excellent communication and negotiation skills

Ability to prioritize and manage multiple tasks efficiently

Education

Bachelor's degree in Nursing or related field

Job description

Michael Hill MD and Associates United States

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Company Description

Michael Hill, MD and Associates focuses on payment disputes between payors and hospitals. We review clinical records, claim adjudication histories and form an opinion on the resolution of the individual claims.

Role Description

This is a part time remote role for a Payor Dispute Nurse Reviewer at Michael Hill, MD and Associates. The Payor Dispute Nurse Reviewer will be responsible for reviewing hospital payment disputes with insurance companies, ensuring accurate reimbursement for provided services. The Nurse Reviewer will have had 5-7 years of experience in case management, utilization management, or claim denial management with either a hospital provider or payor.

Qualifications

• Nursing experience with medical record review and denial management,
• Knowledge of healthcare billing and revenue cycle management
• Strong analytical and problem-solving skills
• Detail-oriented and able to work independently
• Experience in payer disputes and claims resolution
• Excellent communication and negotiation skills
• Ability to prioritize and manage multiple tasks efficiently
• Bachelor's degree in Nursing or related field

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Full-time

Job function

• Job function

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