Nurse Auditor

The role

The Nurse Auditor will support revenue integrity through charge audit and billing validation. This person will review medical records and itemized bills to ensure accuracy and compliance with payer and regulatory requirements.

What you will do

• 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, duplicate, or unsupported charges.
• Validate charges based on clinical documentation, coding rules, and billing guidelines.
• Ensure billing aligns with CMS, payer requirements, and organizational standards.
• Submit actionable audit findings to revenue cycle teams.
• Analyze audit findings to determine root causes and patterns.
• Maintain accurate, traceable, and defensible audit documentation.
• Track audit outcomes and financial impact.
• Partner with coding, billing, clinical, and revenue cycle teams.

Required qualifications

• Active Registered Nurse (RN) license or LPN license
• 5+ years of clinical nursing experience
• Experience performing charge audits
• Experience performing chart reviews
• Experience performing billing validation
• Strong understanding of medical record documentation and hospital billing processes
• Knowledge of CPT, HCPCS, ICD-10 coding basics
• Knowledge of revenue codes and charge capture processes
• Knowledge of inpatient and outpatient billing rules
• Familiarity with Medicare, Medicaid, and commercial payer billing guidelines
• Familiarity with CMS regulations and compliance expectations
• Ability to interpret itemized bills, clinical documentation, and diagnostic reports

Nice to have

• ICU, ED, OR, or acute care experience
• Prior experience in revenue integrity or healthcare auditing
• Prior experience in denials or utilization review
• Familiarity with DRG concepts (MS-DRG or APR-DRG)
• Familiarity with audit or compliance programs
• Experience educating staff or supporting process improvements

Benefits

• Medical, dental, vision and life insurance
• Short/long-term disability
• 401(K)
• Referral bonuses
• Training opportunities
• Reimbursement for professional certifications
• Birthday recognition
• Holiday gift selections
• Performance awards
• Years of service awards

About the company

UASI is an employer of choice with an outstanding reputation for excellence within the industry.