Remote Hospital Bill Audit Nurse I | WFH

Job Overview

We are seeking a meticulous and seasoned Registered Nurse with a strong commitment to ensuring precision in hospital billing practices. As a Hospital Bill Audit Nurse, you will be responsible for performing thorough audits of hospital billing charges by examining medical records and confirming that services are accurately documented and billed in accordance with industry regulations. This position offers the advantage of remote work, along with the necessity for occasional travel to provider locations for onsite audits.

Key Responsibilities

In This Role, Your Primary Responsibilities Will Include

• Audit Scheduling & Execution: Organize your assigned workload, uphold timely communication with the Audit Coordinator, and complete audits effectively.
• Travel: Undertake onsite audits at provider locations as required.
• Charge Review: Examine medical records to ensure the accuracy of billed services, identifying discrepancies such as overcharges, undercharges, errors, duplicates, and unbundled items.
• Documentation: Keep precise and comprehensive records of your findings following standardized documentation protocols.
• Compliance: Adhere to all HIPAA regulations, confidentiality policies, and provider/internal guidelines.
• Problem Resolution: Address any challenges encountered during the audit process by reporting them to supervisors for prompt resolution.
• Collaboration: Represent the organization in a professional manner, working effectively with internal teams and external providers.
• Additional Tasks: Perform other duties as assigned by management.
  
  

Required Skills

To thrive in this position, the following skills are essential:

• Technical Knowledge: Familiarity with hospital billing/charging processes, including UB-04 forms, itemized bills, revenue codes, CPT/HCPCS codes, and ICD-10 coding.
• Industry Expertise: A strong understanding of CMS, payor guidelines, and industry standards is highly desirable.
• Technical Proficiency: Proficient in computer skills, including Microsoft Office (especially Excel), with the capability to engage in virtual meetings.
• Attention to Detail: Outstanding focus and organizational skills to guarantee precise outcomes.
• Communication: Strong verbal and written communication skills for effective collaboration with teams and clients.
• Critical Thinking: Advanced problem-solving and decision-making skills to navigate fast-paced and high-pressure situations.
  
  

Qualifications

The ideal candidate will possess:

• An Associate Degree in Nursing or a higher qualification.
• An active RN license in the state of employment.
• Preferred: At least 5 years of clinical experience as a Registered Nurse in OR, ICU, or ER settings.
• Prior experience in medical bill auditing is preferred.
• Background in hospice care is an advantage.
  
  

Career Growth Opportunities

This role presents a distinctive opportunity for you to leverage your clinical expertise while contributing to billing accuracy and compliance in healthcare, paving the way for advancement within the healthcare sector.

Compensation And Benefits

• Employment Type: Remote (with occasional onsite travel).
• Pay Range: \(60,846 - \)90,940 (dependent on experience, location, and qualifications).
• Comprehensive benefits package, including healthcare, paid time off, and retirement savings options.
  
  

Why Join Us?

By joining our organization, you will find a supportive environment that values professionalism, precision, and teamwork. This role allows you to work independently while being an integral part of a team that prioritizes your expertise and contributions.

Employment Type: Full-Time