Medical Auditor

BayCare Health System; Clearwater (FL); Remote; USD 70,000 - 90,000; Full time

Job summary

BayCare Health System seeks a dedicated nursing professional to verify billing accuracy by comparing charges with supporting documentation. You will act as a systems representative for insurance audits, researching patient and internal billing questions while maintaining an audit log.

Some local travel is required, with a primarily remote role based in Florida. The ideal candidate holds an RN in Florida, preferably a BSN, with strong clinical experience, excellent communication, and solid MS

Qualifications

• RN license in Florida (current).
• Associate degree in nursing; BSN preferred.
• Clinical nursing experience required.
• Ability to review and analyze medical documentation and billing records.
• Strong organizational, auditing and problem-solving skills.
• Excellent communication and collaboration abilities.
• Some travel within the local geographic area.

Responsibilities

• Compare detailed charges on bills to supporting documents to verify validity.
• Serve as Systems representative for insurance audits.
• Research patient and internal billing questions.
• Separate organ donor charges and maintain audit logs.
• Assist with audits and related projects as assigned.

Skills

Auditing

Communication

Collaboration

Problem solving

Education

Associate degree in Nursing (RN)

BSN preferred

Tools

MS Excel

Job description

At BayCare, we are proud to be one of the largest employers in the Tampa Bay area. Our network consists of 16 community-based hospitals, a long-term acute care facility, home health services, outpatient centers and thousands of physicians. With the support of more than 30,000 team members, we promote a forward-thinking philosophy that’s built on a foundation of trust, dignity, respect, responsibility and clinical excellence.

Position Summary

Compares the detailed charges on a bill to the supporting documentation to verify the validity of the charges included on the bill, serve as the Systems representative for insurance audits, research patient and internal billing questions, separates organ donor charges, and maintains a log of all chart audit requests and the related results. Performs audit assists/special projects as assigned.

Minimum Qualifications

• Associate Degree in Nursing (BSN preferred)
• Current Florida Registered Nurse (RN) license
• Clinical nursing experience required
• Ability to review and analyze medical documentation and billing records
• Strong organizational, auditing, and problem-solving skills
• Excellent communication and collaboration skills
• Some travel within the local geographic area is required
• Intermediate MS Excel skills

Preferred Qualifications

• Bachelor's Degree in Nursing (BSN)
• Critical Care experience
• Surgical Services experience

Credentials

• Registered Nurse (RN) – State of Florida

Facility & Location

• Facility: BayCare Health System, Audit Serv Compl Oversight-BCHS
• Location: BayCare System Office West
• Status: Full Time, Exempt
• Shift: 8:00 AM – 4:00 PM
• Primarily Remote (must reside and work within Florida)

Equal Opportunity Employer Veterans/Disabled