Bill Review Nurse (Hybrid) - Summit : Job Details

Headquartered in the Central Florida city of Lakeland, Summit employs over 700 office and field associates at its main location and regional offices in Baton Rouge, Louisiana, and Gainesville, Georgia. As the people who know workers' comp, we strive to provide an atmosphere of constant growth and development for our employees. Summit provides workers' compensation programs and services to thousands of employers throughout the Southeast. Summit is a member of Great American Insurance Group, a company that focuses on building relationships and linking people to various career paths. Whether it's underwriting, claims, accounting, IT, legal, or customer service, Great American Insurance Group combines a small-company entrepreneurial atmosphere with big- company expertise.It's one thing to know workers' comp. It's another to know people. But knowing both? That creates an altogether different experience.So, if you're ready for an altogether different workplace experience, get to know the people who know workers' comp. Apply today.Essential Job Functions and Responsibilities

• Reviews facility & outpatient bills as it compares with medical records, diagnosis & agreements for appropriateness or inconsistencies.
• Negotiates post-service surgical bills.
• Performs audits seeking potential leakage and/or system or procedural improvements.
• Provides professional advice and expertise to Claims staff in developing and providing medical and cost control procedures.
• Provides technical advice to lower level associates and other functional areas.
• Assists with special projects as needed
• May have responsibility for performance and coaching of staff and may have a participatory role in decisions regarding talent selection, development, and performance management for direct reports.
• Performs other duties as assigned.

#LI-Hybrid Job RequirementsEducation: Bachelor's Degree in Nursing or Health related field.R.N. (Registered Nurse) or L.P.N. (Licensed Practical Nurse) preferred, CPC certification (Certified Professional Coder), and clinical experience.Experience: Generally, 10 or more years of related experience, including Case Management experience, working knowledge of health insurance and Workers Compensation.Company:SCI Summit Consulting, LLCSalary Range:$77,900.00 -$106,400.00Benefits: The wage range for this job is based on role, level, and location. Within the range, individual pay takes into account a variety of factors that are considered in making compensation decisions including but not limited to skills, education, training, licensure and certifications, experience of the candidate, the role's scope, complexity, and other business and organizational needs. In addition to the base compensation, we offer a competitive Total Rewards package, which includes but is not limited to medical, dental, vision, paid time off, and 401(k) plan for full-time and part-time employees who are eligible for benefits.Your recruiter may be able to tell you more about our total rewards offerings and the specific wage range for the relevant location(s) during the hiring process.