Hospital Bill Auditor III

EXL

Nurse Auditor conducting Hospital Bill Audits and Itemized Bill Reviews. This role involves verifying charges and ensuring compliance with medical documentation standards remotely.

Posted 7/9/2026full-timeRemote • 🇺🇸 United StatesMid-LevelSenior💰 $70,000 - $90,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in hospital bill auditing, including identifying overcharges and unbundled items, while ensuring compliance with HIPAA and regulatory policies. Proficient in managing audit schedules and maintaining effective communication with stakeholders.

Highest-signal resume keywords

Hospital Bill Auditing ExperienceAcute Care Clinical ExperienceLicensed NurseCPC, CCS or CMAS CertificationExcel Proficiency

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Hospital Bill AuditingIdentifying OverchargesIdentifying Unbundled ItemsData EntryAcute Care Clinical Experience

Soft Skills

Interpersonal SkillsCommunication SkillsTask PrioritizationIndependent Work

Certifications & Qualifications

Licensed NurseCPCCCSCMAS

Industry Keywords

HIPAA ComplianceAudit ProcessPayer Unbundling GuidelinesRegulatory PoliciesInformation Security

About the role

Key responsibilities & impact

Review medical records to verify services were provided as billed for Hospital Bill Audit reviews.
Identify overcharges, undercharges and unbundled items.
Identify unbundled items on the itemized bill specific to payer Unbundling Guidelines and provide references and rationale to support review findings.
Onsite Travel – Maintain timely communication with Audit Coordinator regarding scheduling, completion and submission of audits. Abide by the EXL Travel policy while making travel arrangements for onsite audits.
Scheduling Audits: Manage inventory and schedule audits timely by contacting the provider to schedule date and time to perform audits.
Report any problems in the audit process to Manager for resolution.
Comply with HIPAA and other regulations regarding the confidentiality of patient information.
Conduct all job functions and responsibilities in accordance with all company Compliance, Information Security and Regulatory policies, procedures and programs.

Requirements

What you’ll need

Minimum of 5+ years of acute care clinical experience in medical/surgical units
Licensed Nurse with current active license
Minimum 3+ years hospital bill auditing experience on high dollar claims paid at percent of billed charge, payer or provider side
CPC, CCS or CMAS desired
Excel proficiency
Familiarity with basic data entry tasks
Excellent interpersonal and communication skills
Demonstrate ability to prioritize tasks and work independently

Benefits

Comp & perks

For more information on benefits and what we offer please visit us at https://www.exlservice.com/us-careers-and-benefits