Bill Review Nurse - 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

• Must have experience with medical bill review.
• 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.

Job RequirementsEducation: Bachelor's Degree in Nursing or Health related field.R.N. (Registered Nurse) preferred, CPC certification (Certified Professional Coder), and clinical experience.Experience: Generally, 10 or more years of related experience, including Workers Compensation.Company:SCI Summit Consulting, LLCSalary Range:$77,900.00 -$106,400.00Benefits: Compensation varies by role, position level, and location. Individual pay is influenced by skills, education, training, certifications, experience, and the role's scope and complexity, along with business needs.We offer a competitive Total Rewards package, including medical, dental, and vision plans starting on day one, PTO, paid holidays, commuter benefits, an employee stock purchase plan, education reimbursement, paid parental leave/adoption assistance, and a 401(k) plan with company match. These benefits are available to eligible full-time and part-time employees.Your recruiter can provide more details about our total rewards and specific compensation ranges during the hiring process.