Nurse Auditor
New
U
UASIHealthcare Revenue Integrity
RemoteFull-TimeMiddle
Salary not disclosed
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Job Details
- Experience
- 5+ years
- Required Skills
- EHR
Requirements
- Active Registered Nurse (RN) or LPN license.
- 5+ years of clinical nursing experience (ICU, ED, OR, or acute care preferred).
- Experience performing charge audits, chart reviews, and billing validation.
- Strong understanding of medical record documentation and hospital billing processes.
- Knowledge of CPT, HCPCS, and ICD-10 coding basics.
- Knowledge of revenue codes and charge capture processes.
- Familiarity with Medicare, Medicaid, and commercial payer billing guidelines.
- Experience using EHR systems (e.g., Epic, Cerner, Meditech).
- Experience with audit or billing tools/data systems.
- Strong analytical and critical thinking skills.
- High attention to detail and accuracy.
Responsibilities
- 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, duplicate, or non-compliant charges.
- Validate charges based on clinical documentation, coding rules, and billing guidelines.
- 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.
- Partner with coding, billing, clinical departments, and revenue cycle leadership to provide guidance on documentation and compliance.
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