Nurse Auditor

AuditorAuditorFull TimeRemoteSeniorTeam 1-10Since 2001H1B No SponsorCompany SiteLinkedIn

Location

United States

Posted

2 days ago

Salary

0

Seniority

Senior

Professional Certificate5 yrs expEnglish

Job Description

Nurse Auditor

Affordable Housing Trust for Columbus and Franklin County

• Perform comprehensive charge audits for inpatient and outpatient services. • Review itemized billing statements against medical records to verify accuracy and completeness. • Identify and document: • Missing charges • Duplicate charges • Unsupported or non-compliant charges • Validate charges based on clinical documentation, coding rules, and billing guidelines. • Ensure all billing aligns with: • CMS and payer requirements • National healthcare billing audit guidelines • Organizational compliance standards • Submit clear, actionable audit findings to revenue cycle teams for correction and rebilling. • Analyze audit findings to determine root causes and patterns. • Maintain accurate audit documentation that is clear, traceable, and defensible. • Track audit outcomes and financial impact. • Assist in developing recommendations to improve charge capture accuracy and billing processes. • Partner with: • Coding and billing teams • Clinical departments • Revenue cycle leadership • Provide guidance on: • Documentation requirements • Charge capture practices • Billing compliance standards • Support education efforts to prevent recurring audit issues.

Job Requirements

  • Active Registered Nurse (RN) license or LPN license
  • 5+ years of clinical nursing experience (ICU, ED, OR, or acute care preferred)
  • Experience performing:
  • Charge audits
  • Chart reviews
  • Billing validation
  • Strong understanding of: Medical record documentation & Hospital billing processes
  • Knowledge of:
  • CPT, HCPCS, ICD-10 coding basics
  • Revenue codes and charge capture processes
  • Inpatient and outpatient billing rules
  • Familiarity with:
  • Medicare, Medicaid, and commercial payer billing guidelines
  • CMS regulations and compliance expectations
  • Ability to:
  • Interpret itemized bills, clinical documentation, and diagnostic reports
  • Identify discrepancies and determine correct billing practices
  • Experience using:
  • EHR systems (Epic, Cerner, Meditech)
  • Audit or billing tools/data systems

Benefits

  • Medical, dental, vision and life insurance, short/long-term disability, 401(K) and referral bonuses
  • Training opportunities and reimbursement for professional certifications
  • UASI's unique approach to employee appreciation which include: birthday recognition, holiday gift selections, performance awards, and years of service awards

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