Title: Hospital Charge Audit Nurse Auditor Registered Nurse
Location: US National
Change Healthcare is a leading healthcare technology company with a mission to inspire a better healthcare system. We deliver innovative solutions to patients, hospitals, and insurance companies to improve clinical decision making, simplify financial processes, and enable better patient experiences to improve lives and support healthier communities.
- Fully Remote – U.S.
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.
Mandatory Travel throughout the United States: 25% travel should be assumed with overnight stays. 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.
- 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
- Graduate of an accredited College or University
- Current R.N. license
- Two years of clinical experience in an acute care hospital
- Two years medical claim review or experience as a utilization nurse
- Experience in use of the electronic medical record (EMR)
- Excellent organizational skills with a strong focus on attention to detail
- Knowledge of acute hospital billing requirement including UB-04s, revenue codes, itemization of charges, CPT codes, HCPCS codes ICD 10 diagnosis and procedure codes
- BSN preferred
- Two years hospital charge audit experience
- Medical coding credentials
- Operating room, ICU experience
- Ability to self-schedule for audits and travel
Working Conditions/Physical Requirements:
General office demands
- Mandatory Travel throughout the United States: 25% travel should be assumed with overnight stays. 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
- Employees in roles that require travel will need to be able to qualify for a company credit card or be able to use their own personal credit card for travel expenses and submit for reimbursement.
- Flexible work environments
- Ready, Set, Grow Career Development Center & access to Change Healthcare University for continuous professional learning & development with more than 5,000 training assets
- Volunteer days, employee giving and matching gifts programs, community awards and dollars for doers, community partnerships
- Employee wellbeing programs and generous health plans
- Educational assistance programs
- US 401(k) or Group RRSP (Canada) savings plans with matching employer contributions
- Be sure to ask our Talent Advisors for more information on location specific benefits and paid time off policies
- *Eligibility for some benefits may be limited or not available for part-time employees, be sure to speak with your Talent Advisor.