Inpatient Hospital Auditor - RN

Assignment Type: 6‑month contract with strong potential for permanent hire 

Work Location: Remote (WFH) — must reside in NJ, PA, or NY 

Schedule: Monday–Friday, standard business hours (flexible start time after training)

Pay:  $40/hr

Job Summary

The Inpatient Hospital Auditor (RN) serves as the lead resource for onsite and remote audits of hospital billing and coding practices. This role conducts desk audits, develops audit tools, identifies institutional trends, and designs audit protocols and special projects. Responsibilities include performing and finalizing per diem reviews, bill verification, DRG validation, utilization review audits, and credit balance audits. The auditor also provides expert guidance on ICD‑10‑CM, DRG assignment, payment methodologies, and auditing standards to internal and external stakeholders.

Key Responsibilities

• Audit discrepancy identification — Detect and present billing inconsistencies; coordinate improper payment referrals through appropriate channels.

• Trend analysis — Identify documentation or billing error patterns, including misinterpretation of provider contract terms.

• Data reporting — Compile audit statistics and prepare reports for accounts, regulatory bodies, and internal teams.

• Process improvement — Review and update audit procedures to align with evolving clinical data review practices and cost‑containment initiatives.

• Staff training — Train new team members on departmental and audit protocols.

• Special projects — Complete additional assignments as directed by management.

• Compliance — Demonstrate knowledge of and adherence to all applicable laws, regulations, and organizational policies.

Qualifications

• Active RN License (required)

• High School Diploma/GED (required)

• Bachelor’s degree in Health Information Management preferred (or equivalent experience)

• Minimum 3 years of experience in a medical records department within an acute care hospital or healthcare facility

• Experience in Inpatient Coding, DRG validation, and ICD‑10‑CM education

• CCS, RHIT, or RHIA certification required (in addition to RN license)

• Strong proficiency with Microsoft Office (Excel, Word, PowerPoint)

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