Job Description
Are you a detail-oriented Registered Nurse with a passion for ensuring accuracy and fairness in healthcare billing? Join our team as a Remote Hospital Bill Audit Nurse and play a crucial role in verifying the integrity of hospital charges.
In this dynamic and remote position, you'll be responsible for conducting thorough hospital bill charge audits by meticulously reviewing medical records. Your expertise will ensure that services rendered are accurately reflected in the charges, adhering to medical documentation and industry guidelines. You'll have the opportunity to audit a variety of cases, including inpatient, outpatient, NICU, and hospice services, identifying overcharges, undercharges, and unbundled items in accordance with payer contracts and industry standards.
What You'll Do:
Independent Scheduling & Travel: Manage your own schedule, maintain clear communication with the Audit Coordinator, and travel to provider locations as needed to perform on-site audits.
Medical Record Review & Verification: Scrutinize medical records to confirm the provision of services and the accuracy of charges, identifying discrepancies such as overcharges, undercharges, unbundled items, errors, duplicates, and routine service, equipment, and supply charges.
Detailed Documentation: Accurately document all identified discrepancies and unsupported charges using standardized guidelines.
Data Analysis & Decision-Making: Analyze audit and data information to make informed decisions and ensure accurate results.
Problem Resolution: Proactively report any challenges encountered during the audit process to your manager or supervisor for timely resolution.
Compliance & Confidentiality: Adhere to all HIPAA regulations and other applicable laws regarding patient information confidentiality, as well as provider and internal policies and guidelines.
Professional Representation: Represent our organization in a professional and knowledgeable manner.
Flexibility & Adaptability: Embrace additional duties and responsibilities as assigned by your manager or supervisor.
What You'll Bring:
Strong knowledge of hospital billing and charging, including UB-04s, itemized bills, revenue codes, CPT/HCPCS codes, and ICD-10 diagnosis and procedure codes.
Familiarity with CMS, payer, and other industry guidelines.
Proficiency in computer skills, including Microsoft Office applications (especially Excel), and the ability to participate in virtual meetings.
Exceptional attention to detail and strong organizational, strategic, and critical thinking skills.
Excellent professional communication skills for positive interactions with internal and external stakeholders.
Ability to thrive in a fast-paced environment and work independently.
Associate Degree in Nursing or higher required.
Active Registered Nurse (RN) license in your state of residence.
Minimum of 5 years of RN experience in the OR, ICU, or ER (highly preferred).
Previous medical bill audit experience (highly preferred).
Hospice experience (a plus).
What We Offer:
Remote Work Flexibility: Enjoy the convenience and flexibility of working from your home office.
Competitive Compensation: The pay range for this position is $60,846 - $90,940, with actual compensation based on factors such as experience, qualifications, and location.
Comprehensive Benefits Package: Access a comprehensive benefits package, including medical, dental, vision, 401(k), and paid time off.
Growth Opportunities: Join a stable and growing organization that values its employees and offers opportunities for career advancement.
Supportive Culture: Be part of a team that embraces core values of accountability, commitment, excellence, integrity, and teamwork.
Meaningful Work: Contribute to ensuring accuracy and transparency in healthcare payments.
We are an equal opportunity employer committed to providing a drug-free workplace and complying with ADA regulations.
Employment Type: Full-Time
Salary: $ 60,846.00 90,940.00 Per Year
Job Tags
Full time, Work at office, Remote work, Work from home, Home office,