Nurse Auditor

Job not on LinkedIn

🔥 0 minutes ago

🇺🇸 United States – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

🔎 Auditor

👻 Ghost score 15%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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📋 Description

• 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, unsupported, or non-compliant charges • Validate charges based on clinical documentation, coding rules, and billing guidelines • Ensure billing aligns with CMS and payer requirements, national healthcare billing audit guidelines, and 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, traceable, and defensible audit documentation • 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, and revenue cycle leadership • Provide guidance on documentation requirements, charge capture practices, and billing compliance standards • Support education efforts to prevent recurring audit issues

🎯 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, 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 • Knowledge of inpatient and outpatient billing rules • Familiarity with Medicare, Medicaid, and commercial payer billing guidelines • Familiarity with CMS regulations and compliance expectations • Ability to interpret itemized bills, clinical documentation, and diagnostic reports • Ability to identify discrepancies and determine correct billing practices • Experience using EHR systems, including Epic, Cerner, or Meditech • Experience using audit or billing tools/data systems • Strong analytical and critical thinking skills • High attention to detail and accuracy • Ability to work independently and manage priorities • Clear and professional written and verbal communication • Ability to translate complex findings into actionable insights • Prior revenue integrity or healthcare auditing experience preferred • Denials or utilization review experience preferred • Familiarity with DRG concepts (MS-DRG or APR-DRG) preferred • Familiarity with audit or compliance programs preferred • Experience educating staff or supporting process improvements preferred

🏖️ Benefits

• Medical, dental, vision and life insurance • Short/long-term disability • 401(K) • Referral bonuses • Training opportunities • Reimbursement for professional certifications • Birthday recognition • Holiday gift selections • Performance awards • Years of service awards

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