Itemized Bill Review Auditor III

🔥 4 minutes ago

🇺🇸 United States – Remote

💵 $70k - $90k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🔎 Auditor

👻 Ghost score 1%

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 itemized bills according to payer unbundling guidelines and provide references and rationale for findings • Maintain timely communication with the Audit Coordinator regarding scheduling, completion and submission of audits • Manage audit inventory and schedule audits by contacting providers to arrange dates and times • Make travel arrangements for onsite audits in accordance with EXL travel policy • Report audit-process problems to the Manager for resolution • Conduct all functions in accordance with company compliance, information security and regulatory policies

🎯 Requirements

• Minimum of 5+ years of acute care clinical experience in medical/surgical units • Licensed Nurse with current active license • Minimum of 3+ years of 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 • Ability to prioritize tasks and work independently • Knowledge of hospital bill auditing, payer-specific unbundling guidelines, industry standards and Medicare guidelines • Strong clinical experience and technical skills • Flexibility for independent scheduling and possible travel to provider locations • Must comply with HIPAA and other patient-information confidentiality regulations

🏖️ Benefits

• Competitive benefit package including medical, dental, vision and 401(k) plan • Exciting, fast-paced and innovative environment • Opportunity to work closely with highly experienced healthcare consultants • Opportunities to learn client business aspects, teamwork and time-management skills • Further growth and development opportunities within EXL Health and beyond • Remote U.S. home office opportunity • 0–10% travel may be required