🖥️ Remote | U.S. (Eastern/Central Time Zone) | Full-Time
💼 About Enlyte
Enlyte combines technology, clinical expertise, and compassion to help people recover after workplace injuries or auto accidents. Whether you’re decoding complex billing or developing strategy, you’ll join a team focused on restoring lives and supporting well-being—with room to grow.
🔍 Role Overview
As a Senior Complex Bill Reviewer, you’ll apply clinical and coding expertise to audit and review complex workers’ compensation medical claims. You’ll determine billing appropriateness, flag discrepancies, and help manage costs without compromising care.
🩺 Requirements
• Active RN, LPN, or LVN license (in good standing) ✅
• 3–5 years of clinical experience (ER, OR/implants, specialty care preferred) 🏥
• Strong proficiency in CPT, HCPCS, ICD-10, and EMR systems 🧠
• Previous experience in medical claims, workers’ comp, or utilization review
• Knowledge of Smart Advisor Plus (or similar bill review platform) a plus
• Coding certification (e.g., RN Certified Professional Coder) is a bonus 📋
• Must meet performance metrics: quality scores, procedural accuracy, bills/hour
📌 Key Responsibilities
• Conduct thorough audits of provider and hospital bills
• Identify unsupported or incorrectly billed codes
• Ensure compliance with state and company billing guidelines
• Use clinical judgment to adjust or approve payments
• Recommend cost-saving measures without affecting treatment plans
• Serve as subject matter expert or training resource when needed
• Prioritize reviews and meet turnaround time & accuracy benchmarks
💰 Salary & Benefits
• 💸 Base salary: $60,000–$70,000/year (based on skills and location)
• 🏥 Full health coverage (Medical, Dental, Vision)
• 🧾 HSA/FSA, Life, and AD&D insurance
• 📚 Tuition reimbursement & continuing education support
• 🧘♀️ Wellness resources + generous PTO policy
• 💼 401(k) with company match
• 🔁 Remote work flexibility, performance-driven culture
🌟 You’re a Fit If You:
• Have a sharp eye for billing discrepancies
• Are fluent in clinical documentation and coding
• Love solving problems and finding efficiencies
• Thrive independently in a remote setting
• Want your work to have real impact—on people’s lives and the bottom line
🎯 What We Believe
We know that diverse teams drive better outcomes. If you don’t meet every qualification but believe you could excel in this role, we encourage you to apply anyway.
📬 Ready to review, decode, and make a difference?
Apply today! 🩺
~ 2 Chicks