Nurse Auditor - Medical Bill Review (Remote)
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Before you apply
SalaryNo pay range posted
LocationChicago, Illinois, United States
Work modehybrid
Typefull-time
SeniorityMid
Experience3–5 yrs
Department3500 Technical Assurance
Company size8+ people
PostedJun 1, 2026 · 5mo ago
Verified live1d ago
At a glanceSummarised by Seekless from the posting.
RN (or LPN) with active professional license or equivalent within states of operation
3-5 years of clinical experience in acute care, surgery and/or orthopedic
Understanding of CPT and ICD-10 codes and Medicare guidelines
Ability to apply knowledge to state fee schedules
A customer service orientation, including strong communication skills
CPC and/or CPC-H certification(s) strongly desired
Specialized training in hospital coding, ortho, neuro, rehab, or ER procedures
Workers’ Compensation medical bill review experience a major plus
Experience in any deposition or litigation cases a plus
Skills
CPT
ICD-10
Benefits
Health insurance
401(k)
Paid time off
Paid holidays
Flexible hybrid schedule
Casual dress code
About the company
Have you ever looked a medical bill and immediately noticed something was wrong? Were you itching to use your expertise to fix it? We’ve been there, too. In fact, that’s how our business was born - and continues to thrive. Rising Medical Solutions is looking for a Nurse Auditor who wants to make their mark in the world of medical cost containment.
About the role
Join our team and maximize client savings by reviewing medical bills from a nurse perspective, including appropriate billing, coding and treatment, fee schedule compliance, over-utilization, and erroneous charges. We pride ourselves on outstanding customer service and work hard to keep our impeccable reputation in the industry.
Responsibilities
In this role, you’ll be a part of our mission by giving clients the information they need to determine case value based on evaluation of medical records and medical billing statements, and will:
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Audit medical and billing records to determine if services provided are reasonable, appropriate and necessary.
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Clinically identify and evaluate any charges not related to the occurrence.
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Verify that charges are in accordance with the services ordered and authorized.
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Initiate appropriate contacts with clients and medical providers as appropriate and necessary.
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Negotiate bills and conduct re-evaluation reviews as required
All while maintaining a human touch, demonstrating sensitivity to culturally-diverse people and situations.
Requirements
•
RN (or LPN) with active professional license or equivalent within states of operation
•
CPC and/or CPC-H certification(s) strongly desired
•
Specialized training in hospital coding, ortho, neuro, rehab, or ER procedures
•
3-5 years of clinical experience in acute care, surgery and/or orthopedic
•
Workers’ Compensation medical bill review experience a major plus
•
Understanding of CPT and ICD-10 codes and Medicare guidelines
•
Ability to apply knowledge to state fee schedules
•
A customer service orientation, including strong communication skills
•
Experience in any deposition or litigation cases a plus
Benefits
•
Competitive benefits package, including health insurance, 401(k) with company match, paid time off, paid holidays, and more.
•
Flexible hybrid schedule with in-office days reserved for training and collaborative meetings
•
Employment within a firm committed to core values, staff development, emerging technology, private ownership, and controlled growth/reinvestment in the future - we frequently promote from within!
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Opportunity to make a difference in reducing health care costs and increasing the value of health care to individuals and their employers.
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A relaxed, yet upbeat work environment
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And for those in the office: casual dress code with unlimited coffee!