Maryland Licensed Nurse Audit Specialist

To ensure minimal uncompensated patient revenues, the full-time Maryland Licensed Nurse Audit Specialist will conduct internal audits of hospital bills, collaborate with external auditors, and educate personnel on clinical reimbursement practices in a remote environment. Key responsibilities Conduct audits of patient medical records and billing to identify discrepancies and negotiate with external auditors Gather and record data for performance reporting, ensuring the integrity of information Communicate with various stakeholders to align on audit policies and assist in the appeals process for denied claims Required qualifications Current active RN registration with the Maryland State Board of Nursing Four years of professional nursing experience, including two years in Utilization Review, Quality Assurance, or Case Management Knowledge of hospital review procedures and third-party payment processes Effective negotiation skills and ability to apply clinical assessment skills to audits Proficiency in personal computer software, including spreadsheets and word processing