Hospital Bill Auditor III

This is a fully remote position, open to applicants in United States.

📋 Description

• Examine medical records to confirm that services were delivered as billed during Hospital Bill Audit reviews.

• Detect overcharges, undercharges, and unbundled items.

• Recognize unbundled items on the itemized bill in accordance with payer Unbundling Guidelines, providing references and justification to support review conclusions.

• Onsite Travel – Ensure timely communication with the Audit Coordinator regarding scheduling, completion, and submission of audits. Follow the EXL Travel policy when arranging travel for onsite audits.

• Scheduling Audits: Oversee inventory and schedule audits promptly by contacting the provider to arrange a date and time for the audits.

• Report any issues encountered during the audit process to the Manager for resolution.

• Adhere to HIPAA and other regulations pertaining to the confidentiality of patient information.

• Execute all job functions and responsibilities in alignment with company Compliance, Information Security, and Regulatory policies, procedures, and programs.

⛳️ Requirements

• A minimum of 5+ years of acute care clinical experience in medical/surgical units.

• Active and current nursing license.

• At least 3+ years of experience in hospital bill auditing on high dollar claims paid as a percentage of billed charges, either on the payer or provider side.

• CPC, CCS, or CMAS certification is preferred.

• Proficient in Excel.

• Familiarity with basic data entry tasks.

• Exceptional interpersonal and communication skills.

• Ability to prioritize tasks and work independently.

🏝️ Benefits

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