Licensed Hospital Bill Auditor

Job Summary

To support hospital charge audits, the remote Licensed Hospital Bill Auditor will conduct reviews of claims to verify appropriate charges, identify discrepancies, and ensure compliance with payer guidelines and regulations.

Key responsibilities

• Review medical records to verify services billed for Hospital Bill Audit reviews
• Identify overcharges, undercharges, and unbundled items based on payer Unbundling Guidelines
• Manage audit scheduling and maintain communication with the Audit Coordinator regarding audit completion

Required qualifications

• Minimum of 5+ years of acute care clinical experience in medical/surgical units
• Current active Licensed Nurse status
• At least 3+ years of hospital bill auditing experience on high dollar claims
• CPC, CCS, or CMAS certification desired
• Proficiency in Excel and familiarity with basic data entry tasks