Senior Nurse Reviewer (Fully Remote)

Partner Company; United States; Remote; USD 78,000 - 99,000; Full time

Benefits offered by this job

Flexible PTO

Health benefits

401(k)

Education assistance

Remote work

Job summary

Partner Company is seeking an experienced registered nurse to support medical billing review and utilization reviews. You will review medical records and itemized bills to ensure billing accuracy and appropriate care, applying clinical judgment to assess medical necessity.

The role is remote, with flexible PTO, health benefits, a 401(k) plan, and education assistance. Requires 5+ years inpatient nursing experience and coding knowledge (CPT/ICD-10/HCPCS).

Qualifications

• Active RN license with 5+ years inpatient clinical experience.
• At least 1 year of itemized bill review and coding knowledge (CPT, ICD-10, HCPCS).
• Ability to apply clinical judgment to assess medical necessity.

Responsibilities

• Review medical records and itemized bills to ensure billing accuracy and appropriate care.
• Apply clinical judgment to assess medical necessity and support compliance.

Skills

RN licensure

Inpatient clinical experience

Coding knowledge (CPT/ICD-10/HCPCS)

Job description

• Review medical records and itemized bills to ensure billing accuracy and appropriate care.
• Apply clinical judgment to assess medical necessity and support compliance.

Requirements:

• Active RN license and 5+ years inpatient clinical experience required.
• 1+ year itemized bill review and coding knowledge (CPT, ICD-10, HCPCS).
• Salary $78k-$99.2k annually based on experience and location.
• Flexible PTO, health benefits, 401(k), education assistance, remote work.

Partner Company

Our partner is a healthcare services company that conducts medical claims and utilization reviews to ensure accurate billing and appropriate care. They offer a collaborative, quality-focused remote environment with opportunities for professional development.