Nurse Auditor – PRN, Anywhere

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United Audit Systems, Inc. (UASI), a rapidly growing healthcare consulting firm seeks to expand its professional team of employees by adding experienced Nurse Auditors to our team on a part-time or PRN basis. The ideal candidate will have a combination of clinical experience in a hospital acute care setting and experience providing reviews of the hospital billing and charging policies. Primary Responsibilities:

  • Perform a variety of audit services including charge audit, compliance audit, medical necessity, denials and other requests as needed. Audits may be performed on a concurrent or retrospective basis
  • Review and analyze the client inpatient and/or outpatient itemized billing statement and the patient medical record and related documentation to identify items that were not billed correctly.
  • Document findings on appropriate form and submit findings to client management staff daily so new billing forms can be generated in hospitals billing systems.
  • Adhere to the National Health Care Billing Audit Guidelines, UASI Code of Conduct and Compliance Program, and the client third party audit policy while performing all duties.
  • Attend meetings with members of client-hospital finance, medical records, and ancillary departments.
  • Educate Client-Hospital personnel on validation and documentation of charges if requested by client contract relationship.
  • Navigate hospitals medical record system and understand where to locate the financial information in relation to the patient payor billing information
Requirements:
  • Medical clinical experience
  • Epic experience (Preferred)
  • InterQual and Medical Necessity experience
  • Ability to read and comprehend itemized billing statement, patient medical record and other laboratory reports
  • Ability to analyze medical information and determine appropriate billing procedures
  • Ability to effectively communicate with others
  • Analytical thinking process
  • Knowledge of basic computer skills
  UASI is the employer of choice due to our outstanding reputation for excellence within the industry and for our comprehensive benefit package which includes:
  • 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
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