Nurse Auditor

UASI; United States; On-site; USD 80,000 - 120,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

Life insurance

Disability insurance

401(k) plan

Referral bonuses

Training opportunities

Employee recognition program

Job summary

UASI is seeking a detail-oriented Registered Nurse Auditor to support revenue integrity through charge auditing and billing validation. The role involves reviewing medical records and itemized bills to ensure accuracy, documentation, and compliance with payer requirements and regulations.

You will analyze audit outcomes, document defensible findings, and collaborate with coding, billing, and revenue cycle leadership to prevent denials and strengthen compliant billing practices.

Qualifications

• Active RN license (or LPN) in good standing.
• 5+ years of clinical nursing experience (ICU/ED/OR or acute care preferred).
• Experience performing chart reviews and understanding hospital billing processes.

Responsibilities

• Perform charge audits for inpatient and outpatient services.
• Review itemized bills against medical records for accuracy.
• Identify missing, duplicate, or non-compliant charges and document findings.
• Submit audit findings with actionable recommendations to revenue cycle teams.

Skills

Analytical thinking

Attention to detail

Independent work

Written communication

Education

RN license or LPN license

Tools

Epic

Cerner

Meditech

Job description

We are seeking a detail-oriented Registered Nurse (RN) Auditor to support revenue integrity efforts with a focus on charge audit and billing validation. In this role, you will review medical records and itemized bills to ensure charges are accurate, properly documented, and compliant with payer and regulatory requirements. Your work will help reduce financial risk, prevent denials, and strengthen accurate, defensible billing practices while supporting overall revenue and compliance goals.

Key Responsibilities

Charge Audit & Billing Validation (Primary Focus)

• 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.

Audit Analysis & Documentation

• 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
• Revenue cycle leadership
• Documentation requirements
• Billing compliance standards
• Support education efforts to prevent recurring audit issues.

Required Qualifications

• Active Registered Nurse (RN) license or LPN license
• 5+ years of clinical nursing experience (ICU, ED, OR, or acute care preferred)
• Experience performing:
• Chart reviews
• Strong understanding of: Medical record documentation & Hospital billing processes

Technical Knowledge & Skills

• 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

Core Competencies

• Strong analytical and critical thinking skills
• High attention to detail and accuracy
• Ability to work independently and manage priorities
• Clear and professional written and verbal communication
• Ability to translate complex findings into actionable insights

Preferred Experience

• Prior experience in:
• Revenue integrity or healthcare auditing
• Denials or utilization review
• Familiarity with:
• DRG concepts (MS-DRG or APR-DRG)
• Audit or compliance programs
• Experience educating staff or supporting process improvements

About UASI

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