Medical Bill Review Senior Nurse

Zurich North America - Schaumburg, IL

Job Title: Medical Bill Review Senior Nurse

Position: Senior Nurse

Job Type: Full Time

Pay: $71,100.00 - $116,500.00 with short-term incentive bonus eligibility set at 10%

Shift:

Work Type: Hybrid

Location

Address:

City: Schaumburg

State: IL

ZIP Code:

Job Responsibilities

Review highly complex medical billing to ensure compliance with regional, country, and local regulations.
Manage medical bill litigation and resolve issues by collaborating with corporate law and Technical Claims.
Prepare, attend, and participate in medical bill hearings or depositions as necessary.
Validate the appropriateness of medical treatment and medical bill charges against compensable injuries.
Accurately review medical bills within appropriate time frames for various jurisdictions.
Assist in identifying fraudulent billings by reporting suspicious activity.
Resolve escalated billing issues by applying medical expertise and referring to relevant policies.
Ensure customer satisfaction by responding to inquiries quickly and professionally.
Adhere to quality standards and participate in monthly peer review audits.
Follow regional laws and regulations to ensure legal compliance.
Improve operational efficiencies by providing recommendations for procedural improvements.
Provide customer service by recognizing and responding to the needs of business partners.
Serve as a technical subject matter expert by training and mentoring lower-level staff.
Maintain confidentiality of claims information.
Participate in educational opportunities to maintain professional certifications.
Contribute to team projects as needed.

Required Skills

Core Skills

Strong communication skills
Knowledge of CPT and ICD-9 and ICD-10 codes
Customer service experience

Preferred Skills

2 or more years of experience in Utilization Review, Case Management, or Workers Compensation
Fundamental knowledge of the insurance industry and claims environment
Strong problem-solving skills
Ability to collaborate across work groups

Requirements

Experience: 2 or more years in Critical Care Unit, Emergency Room, Medical Surgical Facility, or Operating Room OR 4 or more years with an Associate Degree in a related field.

Education: Bachelor’s Degree or Associate Degree.

License & Certification:

Current Registered Professional Nurse license

Schedule:

Business travel as required
Extended hours during peak periods

COVID-19 Requirements: Not Specified

Benefits

Comprehensive employee benefits package
Ongoing career development opportunities
Competitive compensation

Supplemental Pay

Short-term incentive bonuses
Merit increases

Special Notes

Zurich is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race/ethnicity, sex, or protected veteran status.