Senior Hospital Bill Audit Specialist

EXL; Oregon; Híbrido; USD 70.000 - 90.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Competitive benefits

Medical, dental, vision

401(k) plan

Descripción de la vacante

EXL Health in the United States (Oregon area) seeks an Itemized Bill Review Auditor with 5+ years of acute care clinical experience. The role requires an active nursing license and at least 3 years of hospital bill auditing on high-dollar claims.

Travel up to 10% may be required while reviews ensure accuracy per payer guidelines and Medicare policies. You will review medical records, identify overcharges and unbundled items, and support findings with references.

Formación

• Minimum 5+ years of acute care clinical experience in medical/surgical units.
• Licensed Nurse with current active license.
• Minimum 3+ years hospital bill auditing experience on high dollar claims paid at percent of billed charge, payer or provider side.
• CPC, CCS or CMAS desired.
• Excel proficiency.
• Familiarity with basic data entry tasks.
• Excellent interpersonal and communication skills.
• Demonstrate ability to prioritize tasks and work independently.

Responsabilidades

• Review medical records to verify services were provided as billed for Hospital Bill Audit reviews.
• Identify overcharges, undercharges and unbundled items.
• Identify unbundled items on the itemized bill specific to payer Unbundling Guidelines and provide references and rationale to support review findings.
• Onsite Travel - Maintain timely communication with Audit Coordinator regarding scheduling, completion and submission of audits. Abide by the EXL Travel policy while making travel arrangements for onsite audits.
• Scheduling Audits: Manage inventory and schedule audits timely by contacting the provider to schedule date and time to perform audits.
• Report any problems in the audit process to Manager for resolution.
• Comply with HIPAA and other regulations regarding the confidentiality of patient information.
• Conduct all job functions and responsibilities in accordance with all company Compliance, Information Security and Regulatory policies, procedures and programs.

Conocimientos

Acute care

Nurse license

Hospital bill auditing

CPC/CCS/CMAS

Excel

Data entry

Interpersonal skills

Independence

Descripción del empleo

EXL Health in the United States (Oregon area) seeks an Itemized Bill Review Auditor with 5+ years of acute care clinical experience. The role requires an active nursing license and at least 3 years of hospital bill auditing on high-dollar claims.

Travel up to 10% may be required while reviews ensure accuracy per payer guidelines and Medicare policies. You will review medical records, identify overcharges and unbundled items, and support findings with references.