Medical Auditor

BayCare; United States; Remote; USD 65,000 - 90,000; Full time

Job summary

BayCare seeks a Medical Auditor to verify bill charges against documentation, support insurance audits, and respond to patient and internal billing questions. The role combines clinical insight with thorough chart review and log maintenance.

Primarily remote with occasional travel within Florida; 8:00 AM–4:00 PM schedule. Requires RN license in Florida; BSN preferred for advancement.

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.
• BSN degree preferred.
• Critical Care experience preferred.
• Surgical Services experience preferred.

Responsibilities

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

Skills

RN license

Clinical nursing experience

Documentation & billing analysis

Auditing & analytical skills

Communication & collaboration

Travel willingness

Excel proficiency

Organizational skills

Attention to detail

Education

Associate Degree in Nursing

BSN preferred

Bachelor's Degree in Nursing (BSN)

Florida RN license

Tools

MS Excel

Job description

Medical Auditor - 177918

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.

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