Preserving, Creating & Facilitating
Nurse Auditor
Location
United States
Posted
2 days ago
Salary
0
Seniority
Senior
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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