Maryland Licensed Nurse Auditor

To support the auditing of hospital bills, the full-time Maryland Licensed Nurse Auditor will conduct internal audits, collaborate with external auditors, and educate personnel on clinical reimbursement practices while working remotely. Key responsibilities Conducts internal audits of patient service billings and identifies discrepancies in billing Communicates with external auditors and UMMS personnel to ensure compliance with audit policies Provides concurrent review of charge capture prior to claim submission to maximize reimbursement 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 negotiating skills and ability to communicate with insurance companies Proficiency in personal computer software, including spreadsheets and data management tools