Job Description

Job Title: RN Medical Bill Auditor

Location: Remote

Compensation: $80,000 - $90,000 annually, based on years of experience

Benefits: This position is eligible for medical, dental, vision, and 401(k).

About the Opportunity:

Our client is a large, mission-driven healthcare organization seeking an experienced Registered Nurse for a specialized medical bill auditing opportunity. This role offers the opportunity to leverage clinical nursing expertise in a data-driven environment while working closely with internal teams to ensure billing accuracy, compliance, and appropriate documentation.

The ideal candidate is an experienced RN with a strong clinical background in the OR, ICU, or ER who is comfortable reviewing complex medical charges, analyzing supporting clinical information, and making independent determinations regarding billing accuracy.

Work Schedule:

• Full-time position
• Remote work experience preferred
• Works independently within a collaborative team environment

Key Responsibilities:

• Review charges on UB-04s submitted by medical facilities to determine accuracy and appropriateness of billed charges
• Analyze supporting clinical and billing data to validate charges and identify discrepancies
• Apply clinical nursing knowledge and experience to evaluate complex medical charges
• Document final audit conclusions and determinations within the designated computer system
• Collect and analyze supporting data as needed to substantiate audit findings
• Maintain accurate and thorough documentation in accordance with departmental standards
• Apply clinical judgment and independent decision-making when determining billing accuracy
• Maintain compliance with HIPAA regulations and organizational policies
• Work collaboratively with internal teams while managing assigned responsibilities independently
• Maintain current RN licensure and stay current with applicable clinical and departmental standards

Qualifications:

• Current Registered Nurse (RN) license in the state of employment
• Minimum of 5 years of RN experience in the OR, ICU, or ER
• Associate Degree in Nursing (ADN) or higher
• Strong clinical knowledge and ability to apply nursing experience to complex billing reviews
• Strong analytical, critical thinking, and independent decision-making skills
• Ability to work independently while contributing effectively within a team environment
• Experience in medical bill auditing preferred, but not required

Addison Group is an Equal Opportunity Employer. Addison Group provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, genetic information, marital status, amnesty, or status as a covered veteran in accordance with applicable federal, state and local laws. Addison Group complies with applicable state and local laws governing non-discrimination in employment in every location in which the company has facilities. Reasonable accommodation is available for qualified individuals with disabilities, upon request.

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