Nurse Auditor 2

Nurse Auditor 2Change Healthcare is a leading healthcare technology company with a mission to inspire a better healthcare system. We deliver innovative solutions to patients, hospitals, and insurance companies to improve clinical decision making, simplify financial processes, and enable better patient experiences to improve lives and support healthier communities. Change Healthcare is a leading healthcare technology company with a mission to inspire a better healthcare system. We deliver innovative solutions to patients, hospitals, and insurance companies to improve clinical decision making, simplify financial processes, and enable better patient experiences to improve lives and support healthier communities. Work Location: Fully Remote - U.S.Position: The Hospital Charge Audit Nurse RN/LPN will perform remote of both inpatient and outpatient hospital claims as assigned. Audits are conducted as a medical record review of all billed charges to identify over, under and late charges; as well as ensure provider reimbursement is within client guidelines and policies. CDI specialist position will coordinate and maintain the elements and requirements of the Clinical Documentation Improvement Program, including staff and physician education, to ensure the highest quality of documentation in support of compliance and accurate representation of the care provided to the patient.Core Responsibilities: Perform remote hospital bill charge audits as assigned while meeting department quality expectationsManage case inventory to ensure timely scheduling of remote audits while maintaining weekly productivity goalsAbility to assess case details and provide input into audit potential of facilities & casesEffectively interact and communicate with teammates & providers regarding all steps of the audit process. Some interaction with clients may occasionally be required as well.Utilize nursing knowledge in conjunction with interpretation of the medical record to identify discrepancies in billed chargesDevelop recommendations and possible solutions to resolve audit disputes that have resulted in incomplete audit closureOther duties as requestedRequirements: Current R.N. license or LPN/LVN licenseTwo years of clinical experience in an acute care hospitalThree to four years medical claim review or experience as a charge audit nurse performing Concurrent/Retrospective, Third Party Defense, Outpatient and High Dollar patient accounts.Experienced in Infusion and Injection charge hierarchy, Out Pt procedure charges and other charges related.Experience in use of the electronic medical record (EMR)Excellent leadership and organizational skills with a strong focus on attention to detailKnowledge of acute hospital billing requirement including UB-04s, revenue codes, itemization of charges, CPT codes, HCPCS codes ICD 10 diagnosis and procedure codesProficiency with Microsoft office including Outlook, Word and Excel computer skillsPreferred Qualifications: Medical coding credentials a plus but not requiredOperating room, ICU experience and/or other critical care areasAbility to follow up and resolve issues in a timely mannerExcellent critical thinking/problem solving skillsExcellent verbal and written communication skills to include professional communication to facilitiesAbility to work independently as well as recognize when administrative or clinical support is neededAbility to multitask in a fast-paced environmentAbility to organize, plan, prioritize and complete assignments within the required time frameAbility to prepare clear, concise, and legible audit formsWorking Conditions/Physical Requirements: General office demands, remote work from homeMust be able to sit for long periods of time utilizing a computerUnique Benefits*: Flexible work environmentsReady, Set, Grow Career Development Center & access to Change Healthcare University for continuous professional learning & development with more than 5,000 training assetsVolunteer days, employee giving and matching gifts programs, community awards and dollars for doers, community partnershipsEmployee wellbeing programs and generous health plansEducational assistance programsUS 401(k) or Group RRSP (Canada) savings plans with matching employer contributionsBe sure to ask our Talent Advisors for more information on location specific benefits and paid time off policiesLearn more at *Eligibility for some benefits may be limited or not available for part-time employees, be sure to speak with your Talent Advisor.Diversity and Inclusion: At Change Healthcare, we include all. We celebrate diversity and inclusivity, respect each other and value our unique experiences. By being our authentic selves, we bring different perspectives into our work and relationships. Business Resource Groups (BRGs) play a central role in advancing diversity and inclusion at Change Healthcare. They deepen our understanding of different cultures, people, and experiences, and help foster an inclusive workplace. Change offers eight (8) BRGs. Learn more at /diversity Feeling Inspired? Ready to MakeAChange? Apply today! Diversity and Inclusion: At Change Healthcare, we include all. We celebrate diversity and inclusivity, respect each other and value our unique experiences. By being our authentic selves, we bring different perspectives into our work and relationships.Business Resource Groups (BRGs) play a central role in advancing diversity and inclusion at Change Healthcare. They deepen our understanding of different cultures, people, and experiences, and help foster an inclusive workplace. Change offers eight (8) BRGs. Learn more at /diversity Feeling Inspired? Ready to MakeAChange? Apply today! COVID Vaccination Requirements We remain committed to doing our part to ensure the health, safety, and well-being of our team members and our communities. As such, we require all employees to disclose COVID-19 vaccination status prior to beginning employment and, when j ob-related and consistent with business necessity , we may require periodic testing for certain roles. Some roles require full COVID-19 vaccination as an essential job function. Change Healthcare adheres to COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance.Equal Opportunity/Affirmative Action Statement Change Healthcare is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, genetic information, national origin, disability, or veteran status. To read more about employment discrimination protections under federal law, read EEO is the Law at and the supplemental information at you need a reasonable accommodation to assist with your application for employment, please contact us by sending an email to [Click Here to Email Your Resumé] with ''Applicant requesting reasonable accommodation'' as the subject. Resumes or CVs submitted to this email box will not be accepted.Click here English_formattedESQA508c.pdf to view our pay transparency nondiscrimination policy.California (US) Residents: By submitting an application to Change Healthcare for consideration of any employment opportunity, you acknowledge that you have read and understood Change Healthcares Privacy Notice to California Job Applicants Regarding the Collection of Personal Information (. Change Healthcare maintains a drug free workplace and conducts pre-employment drug-testing, where applicable, in accordance with federal, state and local laws.Change Healthcare is an equal opportunity employer. All qualified applicant will reveive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, genetic information, national origin, disability, or veteran status.

Created: 2025-10-04