Itemized Bill Review Auditor III

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EXL

WebsiteLinkedInAll Job Openings

10,000+ employees

💰 $2M Venture Round on 2015-01

Choosing a digital partner is about more than capabilities — it’s about collaboration and character.

📋 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

• Competitive benefit package including medical, dental, vision and 401(k) plan.