RN Hospital Billing & Charge Audit Specialist

CorVel Corporation; Oregon; Hybrid; USD 64,000 - 95,000; Full time

Job summary

CorVel Corporation seeks a Hospital Bill Audit Nurse to conduct hospital bill charge audits by reviewing medical records and validating charges. Travel to provider locations is required, and audits may include inpatient, outpatient, NICU, and hospice settings.

The role emphasizes accuracy, HIPAA compliance, and collaboration with the Audit Coordinator to ensure timely, thorough audits and professional representation of CorVel/CERIS.

Qualifications

• Associate degree in nursing or higher is required.
• Current RN licensure in the state of employment is required.
• Experience in hospital billing/audit preferred (external or internal).
• Minimum five years in OR/ICU/ER as RN preferred; hospice experience a plus.

Responsibilities

• Schedule and complete audits efficiently; travel onsite as needed.
• Review medical records to verify services and charges.
• Identify overcharges/undercharges and unbundled items.
• Document findings with standard guidelines; ensure HIPAA compliance.
• Communicate with Audit Coordinator and manager; escalate issues as needed.

Skills

Hospital billing

CMS guidelines

Communication skills

MS Office / Excel

Attention to detail

Organizational skills

Independent work

Travel onsite

Education

Associate Degree in Nursing or higher

RN licensure in state of employment

Tools

Microsoft Excel

Job description

CorVel Corporation seeks a Hospital Bill Audit Nurse to conduct hospital bill charge audits by reviewing medical records and validating charges. Travel to provider locations is required, and audits may include inpatient, outpatient, NICU, and hospice settings.

The role emphasizes accuracy, HIPAA compliance, and collaboration with the Audit Coordinator to ensure timely, thorough audits and professional representation of CorVel/CERIS.