Hospital Bill Auditor III

Job not on LinkedIn

🕒 July 9

🇺🇸 United States – Remote

💵 $70k - $90k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🔎 Auditor

👻 Ghost score 4%

What it means: how likely this posting is sitting open without active hiring.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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EXL

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

🛡️ Insurance

📦 Logistics

💰 $2M Venture Round on 2015-01

Healthcare • Insurance • Logistics

EXL is a business consulting and services firm that focuses on leveraging data to enhance business operations and decision-making. With a strong emphasis on collaboration and adaptability, EXL partners with organizations to address their unique needs and culture while integrating data science and technology solutions. The company's areas of expertise include operations management, decision analytics, digital transformation, and various industries such as healthcare, finance, and insurance. EXL's mission is to help clients drive business evolution and maintain competitive advantage through tailored solutions and effective use of data.

📋 Description

• Review medical records to verify services were provided as billed for Hospital Bill Audit reviews. • Identify overcharges, undercharges and unbundled items. • Identify unbundled items on the itemized bill specific to payer Unbundling Guidelines and provide references and rationale to support review findings. • Onsite Travel – Maintain timely communication with Audit Coordinator regarding scheduling, completion and submission of audits. Abide by the EXL Travel policy while making travel arrangements for onsite audits. • Scheduling Audits: Manage inventory and schedule audits timely by contacting the provider to schedule date and time to perform audits. • Report any problems in the audit process to Manager for resolution. • Comply with HIPAA and other regulations regarding the confidentiality of patient information. • Conduct all job functions and responsibilities in accordance with all company Compliance, Information Security and Regulatory policies, procedures and programs.

🎯 Requirements

• Minimum of 5+ years of acute care clinical experience in medical/surgical units • Licensed Nurse with current active license • Minimum 3+ years hospital bill auditing experience on high dollar claims paid at percent of billed charge, payer or provider side • CPC, CCS or CMAS desired • Excel proficiency • Familiarity with basic data entry tasks • Excellent interpersonal and communication skills • Demonstrate ability to prioritize tasks and work independently

🏖️ Benefits

• For more information on benefits and what we offer please visit us at https://www.exlservice.com/us-careers-and-benefits