RN Hospital Bill Auditor - Remote

Certilytics   Louisville , KY   Full-time     Nursing
Posted on May 4, 2023
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Tracking Code 050323

Job Description

The primary purpose of this full time position is to perform both on and off site providing support to the Payment Integrity office and per-diem nurse staff. The candidate for this position must be willing to perform audits within the locations identified in the job posting, while infrequent, must be willing to travel other states on an as needed basis, with advanced notification. The Auditor will complete audits following department guidelines and client established parameters. The Auditor must be motivated, a self-starter and able to work independently. Must actively participate with other staff as part of an effective work team.

The travel will be in the state of Maryland.  Any surrounding areas are eligible for travel to MD, such as New Jersey, Southeastern PA, DE, or VA.


Essential Function

Perform onsite and offsite audit of assigned cases comparing the I-bill to the medical record.

-Review findings with hospital representative and obtains an agreement on the discrepancies.

–Updates assigned audits utilizing company provided equipment.

-Good rapport with hospital auditors, medicals records department and business office staff.

-Identifies any hospital related issues and recommends possible solution. Will resolve when appropriate.

-Acts as liaison and troubleshooter between providers and Carewise Health.

-Demonstrate tact and understanding in handling problems.

-Meet scheduling deadlines and completes audit reports based on established productivity standards.

-Follows up on audits timely based on established productivity standards.

-Reviews worksheets and totals by category with the bill to ensure a match.

-Re-checks audit mathematical computations before submitting completed audit to office and in accordance with established quality standards.

-Provide support and resource for other nurse auditors.

-Interaction with internal PI leadership and remote MBRPI auditors on regular basis.

-Provide support for workflow management.

-Assist department with special projects as needed.

-Maintains workflow and timelines for all client deliverables

-All other duties as assigned.


Carewise Health provides a generous benefits package including:

 Medical Insurance
 Dental Insurance
 Life Insurance
 Vision Insurance
 Paid Vacation
 Paid Holidays
 Paid Sick Days
 Short Term Disability
 Long Term Disability
 401K Plan With Company Match
 Tuition Reimbursement
 Employee Assistance Program

All benefits are effective on the first day of employment with the exception of tuition reimbursement and STD/LTD, which is effective after 90 days of employment.

Attention Staffing Agencies: This position is not open for agency submittals. Any candidate submitted without HR approval will be considered an applicant of Carewise Health, not the agency. All Agency Candidates must first be submitted to HR.

EOE Disability/Veterans

Required Skills/Requirements

-Must be a registered nurse with a valid license

-Associate’s degree in nursing required.

-ICU experience required

-Hospital auditing experience preferred.

-Proficiency in Excel and Word is required.

-Additional training in medical terminology of related fields a plus.

-Strong leadership skills.

-An ability to communicate effectively and work with team during high-stress projects.

-Ability to prioritize multiple tasks.

-Maintains open communication.

-Strong verbal and written communication skills.

Salary is available to disclose. 

Job Location:

Remote, Maryland, United States


Type Full-Time/Regular

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