Hospital Charge Audit Nurse Auditor RN

Change Healthcare

Hospital Charge Audit Nurse Auditor RN

Overview of Position
The Hospital Charge Audit Nurse Auditor RN will perform remote and onsite hospital charge audits of both inpatient and outpatient hospital claims as assigned.  Audits are conducted as a medical record review of all billed charges to identify over, under and late charges; as well as ensure provider reimbursement is within client guidelines and policies. These are not DRG or medical necessity audits.  50% travel should be assumed with overnight stays. Depending on Access to a major airport is required. Employee may live in any state. Depending on volume of work and employee location, required travel may be by car, air or both.

What will be my duties and responsibilities in this job?

  • Perform remote and onsite hospital bill charge audits as assigned while meeting department quality expectations
  • Manage case inventory to ensure timely scheduling of remote and onsite audits while maintaining weekly productivity goals
  • Ability to assess case details and provide input into audit potential of facilities & cases
  • Effectively interact and communicate with teammates & providers regarding all steps of the audit process.  Some interaction with clients may occasionally be required as well.
  • Utilize nursing knowledge in conjunction with interpretation of the medical record to identify discrepancies in billed charges
  • Develop recommendations and possible solutions to resolve audit disputes that have resulted in incomplete audit closure
  • Other duties as requested

Link to position details:


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