Remote RN Itemized Billing Auditor

Machinify; United States; Remote; USD 80,000 - 90,000; Full time

Benefits offered by this job

Work from anywhere in the US

Job summary

Machinify, a leading healthcare intelligence company, seeks a Nurse Itemized Bill Reviewer (IBR Analyst) to review facility insurance claims and determine true charges using UB-04 and itemized statements. The role requires clinical expertise, knowledge of CPT/ICD-9/10/HCPCS, and attention to accuracy.

You’ll work remotely from anywhere in the US, collaborating with senior analysts and cross-functional teams to ensure compliant, timely reviews and to support ongoing process improvements with a

Qualifications

• Active RN, LPN, or LVN license in good standing.
• Equivalent experience of 1+ years in itemized bill review.
• Equivalent experience of 2+ years in healthcare billing and coding.
• Experience applying payer policies and national coding guidelines such as CPT, ICD-9/10, and HCPCS.
• Ability to research and verify billing and coding accuracy.
• Possess significant attention to detail and excellent written and verbal skills.
• Excellent organizational, analytical, and problem-solving skills.
• Capable of handling multiple projects in a fast paced, hyper-growth environment.
• Strong ability to work independently and work with internal teams communicating change across the business.

Responsibilities

• Perform an in-depth review of medical claims utilizing the UB-04 and detailed itemized statement to ensure the validity of line-item charges.
• Verify accuracy of the itemized charges to be reimbursed according to client policy and industry standards.
• Validate automatic system denials and create additions to enhance efficient processing of IBR claims.
• Recommend system enhancements and edits to improve claim review efficiency.
• Comply with company standards regarding accuracy and productivity to manage daily assignments and meet client turnaround times.
• Consult with Senior Analysts with any questions and/or issues related to claim reviews.
• Assist in content development, automation, research, and appeal responses as needed.
• Provide input and collaboration concerning content development with internal groups and on global projects as needed.
• Attend all required meetings.
• Assists in special projects and perform other duties as needed.

Skills

RN/LPN/LVN license

Itemized bill review

Healthcare billing & coding

Payer policy & coding guidelines

Billing research

Attention to detail

Analytical skills

Time management

Independent work

Remote collaboration

Tools

Windows Office

Excel

PowerPoint

Word

Teams

Job description

Machinify, a leading healthcare intelligence company, seeks a Nurse Itemized Bill Reviewer (IBR Analyst) to review facility insurance claims and determine true charges using UB-04 and itemized statements. The role requires clinical expertise, knowledge of CPT/ICD-9/10/HCPCS, and attention to accuracy.

You’ll work remotely from anywhere in the US, collaborating with senior analysts and cross-functional teams to ensure compliant, timely reviews and to support ongoing process improvements with a