Job Description:
• Perform comprehensive charge audits for inpatient and outpatient services.
• Review itemized billing statements against medical records to verify accuracy and completeness.
• Identify and document:
• Missing charges
• Duplicate charges
• Unsupported or non-compliant charges
• Validate charges based on clinical documentation, coding rules, and billing guidelines.
• Ensure all billing aligns with:
• CMS and payer requirements
• National healthcare billing audit guidelines
• Organizational compliance standards
• Submit clear, actionable audit findings to revenue cycle teams for correction and rebilling.
• Analyze audit findings to determine root causes and patterns.
• Maintain accurate audit documentation that is clear, traceable, and defensible.
• Track audit outcomes and financial impact.
• Assist in developing recommendations to improve charge capture accuracy and billing processes.
• Partner with:
• Coding and billing teams
• Clinical departments
• Revenue cycle leadership
• Provide guidance on:
• Documentation requirements
• Charge capture practices
• Billing compliance standards
• Support education efforts to prevent recurring audit issues.
Requirements:
• Active Registered Nurse (RN) license or LPN license
• 5+ years of clinical nursing experience (ICU, ED, OR, or acute care preferred)
• Experience performing:
• Charge audits
• Chart reviews
• Billing validation
• Strong understanding of: Medical record documentation & Hospital billing processes
• Knowledge of:
• CPT, HCPCS, ICD-10 coding basics
• Revenue codes and charge capture processes
• Inpatient and outpatient billing rules
• Familiarity with:
• Medicare, Medicaid, and commercial payer billing guidelines
• CMS regulations and compliance expectations
• Ability to:
• Interpret itemized bills, clinical documentation, and diagnostic reports
• Identify discrepancies and determine correct billing practices
• Experience using:
• EHR systems (Epic, Cerner, Meditech)
• Audit or billing tools/data systems
Benefits:
• Medical, dental, vision and life insurance, short/long-term disability, 401(K) and referral bonuses
• Training opportunities and reimbursement for professional certifications
• UASI's unique approach to employee appreciation which include: birthday recognition, holiday gift selections, performance awards, and years of service awards