Hospital Bill Auditor III (HBA)
About The Position
The Nurse Auditor conducts hospital charge audits on claims paid at percent of billed charges to verify charges are appropriate and supported by documentation in the medical record. Charge audits identify overcharges, undercharges and unbundled items per carrier contract, industry standards and payer reimbursement policies. Itemized Bill Review knowledge is required with regard to Unbundling Guidelines specific to payer policy, industry standards and Medicare Guidelines. The nurse will also be responsible for independent scheduling requiring flexibility and possible travel to provider location. The position requires strong clinical experience and technical skills.
Requirements
- Strong clinical experience
- Technical skills
- Itemized Bill Review knowledge
- Knowledge of Unbundling Guidelines specific to payer policy, industry standards and Medicare Guidelines.
Nice To Haves
- Flexibility
- Possible travel to provider location
Responsibilities
- Conduct hospital charge audits on claims paid at percent of billed charges to verify charges are appropriate and supported by documentation in the medical record.
- Identify overcharges, undercharges and unbundled items per carrier contract, industry standards and payer reimbursement policies.
- Perform Itemized Bill Review with knowledge of Unbundling Guidelines specific to payer policy, industry standards and Medicare Guidelines.
- Independently schedule audits, requiring flexibility and possible travel to provider location.
Benefits
- For more information on benefits and what we offer please visit us at https://www.exlservice.com/us-careers-and-benefits
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
