Upvote
Downvote
Director of Specialty Bill Review Services - Remote
Share Job
- Suggest Revision
Remote
- As our Director of Specialty Bill Review Services, you will maximize savings and client satisfaction by providing strategic direction for Rising's Specialty Services unit involving complex/large medical claims; analyzing and optimizing bill review procedures and systems; and leading a team of experienced medical bill review auditors, nurse auditors, med-legal nurse, negotiators and related staff in an environment of continual performance improvement.
- Act as Operations SME for capturing savings and fee allocation to optimize revenue
- Keep informed on issues and trends relating to Healthcare, Workers Compensation, Bill Review, Cost Containment, Managed Care, and related areas
- Monitor changes in State and Federal laws, rules or fee schedules that impact medical bill review/re-pricing and ensure they are integrated into workflows (and Smart Advisor via Mitchell) for proper adjudication
- Prepare legal/settlement assessments, manage litigation/bill disputes, respond to defense attorney requests, and provide testimony as an expert witness as required
Active Job
Updated 16 days agoSimilar Job
Relevance
Active