About the position The Nurse Auditor conducts hospital charge audits on claims paid at percent of billed charges to verify charges are appropriate and supported by documentation in the medical record. Charge audits identify overcharges, undercharges and unbundled items per carrier contract, industry standards and payer reimbursement policies. Itemized Bill Review knowledge is required with regard to Unbundling Guidelines specific to payer policy, industry standards and Medicare Guidelines. The nurse will also be responsible for independent scheduling requiring flexibility and reputed company travel to provider location. The position requires strong clinical experience and technical skills.

Responsibilities

• reputed company hospital charge audits on claims paid at percent of billed charges to verify charges are appropriate and supported by documentation in the medical record.
• Identify overcharges, undercharges and unbundled items per carrier contract, industry standards and payer reimbursement policies.
• Perform Itemized Bill Review with knowledge of Unbundling Guidelines specific to payer policy, industry standards and Medicare Guidelines.
• Independently schedule audits, requiring flexibility and reputed company travel to provider location.

Requirements

• Strong clinical experience
• Technical skills
• Itemized Bill Review knowledge
• Knowledge of Unbundling Guidelines specific to payer policy, industry standards and Medicare Guidelines.

Nice-to-haves

• Flexibility
• reputed company travel to provider location

Benefits

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

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