Hospital Bill Audit Manager

Hospital Bill Audit Manager

Responsible for planning, leading and coordinating a team of registered nurse hospital bill auditors. This team performs on site and remote hospital bill audits. This is a remote role.

Essential Functions & Responsibilities :

• Utilize nursing education, experience and industry best practices to lead a team of registered nurses to plan, execute and deliver timely and accurate provider hospital bill audits
• Direct the training, professional development, and retention for the nurse auditors
• Ensure accuracy of audits through acquired knowledge of client policies, provider contract information, and other standard guidelines
• Assist in the development and support of auditors to meet and exceed productivity requirements based on CERiS productivity standards
• Act as a point of contact to answer and resolve auditor issues with the goal of providing excellent customer service and relationship management
• Perform audits as necessary
• Responsible for managing the daily file flow coming into Medical Review while maintaining awareness of potential file flow from other departments to track rush or special files, test files, pilot studies for prospective clients
• Acknowledge and oversight of work assigned, maintain timely communication with Audit Coordinator, schedule and complete audits in an efficient and timely manner
• Research and respond to staff questions and concerns in a timely, professional manner
• Oversee performance evaluations for direct report staff for approval by VP of Operations on annual basis in accordance with company best practices
• Responsible for human resources matters directly related to department staff under direct supervision including documentation of events or occurrences and verbal counseling direct report staff when attendance or performance deficiencies are discovered
• Responsible for payroll matters directly related to department staff under direct supervision including documentation or direct communication with payroll department
• Assist with scheduling and initial screening of candidates for open positions, reporting to VP of Operations with final decision
• Participate in provider calls and meetings for designated clientele
• May be required to travel overnight and attend meetings or training for Hospital Bill Audit review. Must be willing to travel to provider facilities for onsite audits as needed
• Additional duties as assigned executive leadership

Knowledge & Skills :

Education & Experience :

Pay Range : $85,230 $131,586

A list of our benefit offerings can be found on our CorVel website.

CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.