RN Audit Specialist - Revenue Integrity & Denials

University of Maryland Medical System; Linthicum (MD); On-site; USD 85,000 - 110,000; Full time

Job summary

University of Maryland Medical System is seeking an RN with substantial auditing experience to conduct internal audits of hospital bills and collaborate with external auditors. The role focuses on minimizing uncompensated revenues and informing UMMS personnel about reimbursement results and practices.

The candidate will evaluate medical records versus charges, identify discrepancies, and coordinate documentation and appeal processes with payers and clinicians to improve denial management and

Qualifications

• Current RN license in Maryland.
• Minimum four years of professional nursing experience, with care setting experience.

Responsibilities

• Plan and execute internal audits of hospital bills with external auditors.
• Identify discrepancies between services billed and services rendered.
• Communicate findings to UMMS personnel and assist in audit documentation.
• Coordinate denials follow-up and appeals with clinical staff and payers.
• Maintain data integrity for audit records and reporting.

Skills

Attention to detail

Communication

Negotiation

Independent work

Data analysis

Education

Maryland RN License

Tools

MIDAS

Excel

Job description

University of Maryland Medical System is seeking an RN with substantial auditing experience to conduct internal audits of hospital bills and collaborate with external auditors. The role focuses on minimizing uncompensated revenues and informing UMMS personnel about reimbursement results and practices.

The candidate will evaluate medical records versus charges, identify discrepancies, and coordinate documentation and appeal processes with payers and clinicians to improve denial management and