Nurse Auditor

At Children's Hospital & Medical Center, we are seeking a highly skilled Nurse Auditor to join our team. As a Nurse Auditor, you will play a critical role in ensuring the accuracy and compliance of our clinical documentation and billing processes.

• Conduct concurrent reviews of patient discharges to reconcile billed charges with clinical records.
• Ensure timely and accurate investigation of account audits by third-party agencies.
• Review and negotiate settlements with third-party agencies, involving the Director of Managed Care as needed.
• Analyze data to identify areas for improvement in charge systems and workflows.
• Intervene to promote compliance with regulatory guidelines and internal policies.
• Assist other Revenue Cycle Teams with supporting clinical documentation in writing payer appeals.

• Bachelor's Degree in Nursing from an accredited college or university.
• Minimum 5 years of clinical nursing experience, with intensive care/med surg experience in a pediatric setting.
• Experience in Hospital Billing Audits.
• Knowledge of CPT/HCPCS codes, regulatory guidelines, and Hospital Billing.

At Children's Hospital & Medical Center, we are committed to providing a supportive and inclusive work environment. We offer competitive compensation and benefits, as well as opportunities for professional growth and development.

We are an equal opportunity employer and welcome applications from diverse candidates. If you are a motivated and detail-oriented individual with a passion for healthcare, we encourage you to apply for this exciting opportunity.