We are seeking a detail-oriented Registered Nurse (RN) Auditor to support revenue integrity efforts with a focus on charge audit and billing validation. In this role, you will review medical records and itemized bills to ensure charges are accurate, properly documented, and compliant with payer and regulatory requirements. Your work will help reduce financial risk, prevent denials, and strengthen accurate, defensible billing practices while supporting overall revenue and compliance goals.

Key Responsibilities

Charge Audit & Billing Validation (Primary Focus)

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 charges
Duplicate charges
Unsupported or non-compliant charges

Validate charges based on clinical documentation, coding rules, and billing guidelines.
Ensure all billing aligns with:

CMS and payer requirements
National healthcare billing audit guidelines
Organizational compliance standards

Submit clear, actionable audit findings to revenue cycle teams for correction and rebilling.

Audit Analysis & Documentation

Analyze audit findings to determine root causes and patterns.
Maintain accurate audit documentation that is clear, traceable, and defensible.
Track audit outcomes and financial impact.
Assist in developing recommendations to improve charge capture accuracy and billing processes.

Collaboration & Education

Partner with:

Coding and billing teams
Clinical departments
Revenue cycle leadership

Provide guidance on:

Documentation requirements
Charge capture practices
Billing compliance standards

Support education efforts to prevent recurring audit issues.

Required Qualifications

Active Registered Nurse (RN) license or LPN license
5+ years of clinical nursing experience (ICU, ED, OR, or acute care preferred)
Experience performing:

Charge audits
Chart reviews
Billing validation

Strong understanding of: Medical record documentation & Hospital billing processes

Technical Knowledge & Skills

Knowledge of:

CPT, HCPCS, ICD-10 coding basics
Revenue codes and charge capture processes
Inpatient and outpatient billing rules

Familiarity with:

Medicare, Medicaid, and commercial payer billing guidelines
CMS regulations and compliance expectations

Ability to:

Interpret itemized bills, clinical documentation, and diagnostic reports
Identify discrepancies and determine correct billing practices

Experience using:

EHR systems (Epic, Cerner, Meditech)
Audit or billing tools/data systems

Core Competencies

Strong analytical and critical thinking skills
High attention to detail and accuracy
Ability to work independently and manage priorities
Clear and professional written and verbal communication
Ability to translate complex findings into actionable insights

Preferred Experience

Prior experience in:

Revenue integrity or healthcare auditing
Denials or utilization review

Familiarity with:

DRG concepts (MS-DRG or APR-DRG)
Audit or compliance programs

Experience educating staff or supporting process improvements

About UASI

UASI is the employer of choice due to our outstanding reputation for excellence within the industry and for our comprehensive benefit package which includes:

Medical, dental, vision and life insurance, short/long-term disability, 401(K) and referral bonuses
Training opportunities and reimbursement for professional certifications
UASI’s unique approach to employee appreciation which include: birthday recognition, holiday gift selections, performance awards, and years of service awards