RN Compliance, Charge Capture Auditor

Carle Health

. Audit accounts prior to billing according to coding, regulatory, and payer policy guidelines .

Posted 9/15/2026full-timeRemote • Illinois • United StatesJuniorMid-Level💰 $29 - $50 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in auditing clinical documentation and charge-related regulations, with a strong focus on Emergency Department charging and compliance with CMS guidelines. Proven ability to manage complex projects, analyze issues, and provide training to clinical staff.

Highest-signal resume keywords

Licensed Registered Nurse (RN)Emergency Department Charging KnowledgeClinical Documentation StandardsCoding and Regulatory GuidelinesProject Management

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Audit AccountsCharge ValidationDocumentation AnalysisIV Infusion and Injection ChargesCharge Anomaly TrackingAd Hoc TrainingInternal Control EvaluationsRegulatory ComplianceIssue InvestigationData Analysis

Soft Skills

Attention to DetailCommunicationLeadershipProblem-SolvingCollaboration

Certifications & Qualifications

Bachelor's Degree in NursingRegistered Nurse License (Illinois)

Industry Keywords

Payer Policy GuidelinesCMS GuidelinesCharge-Related RegulationsPatient Account ChargesObservation Hours

About the role

Key responsibilities & impact

Audit accounts prior to billing according to coding, regulatory, and payer policy guidelines
Address debit and credit charging errors to ensure correct final bills
Audit documentation to ensure chart documentation matches patient account charges
Perform daily audits on Inpatient, Observation, Emergency Department, and Outpatient Infusion accounts
Analyze Observation hours and ensure charges comply with regulations
Submit non-billable Observation hours requiring manual carve-out for charge resolution
Add IV infusion and injection charges according to CMS guidelines
Track and trend charge anomalies and report them to clinical department directors
Provide ad hoc training and retraining to clinical staff
Validate charge appropriateness and ensure completion of documentation with department directors or managers
Plan, coordinate, and conduct audits, internal control evaluations, and reviews
Present project results to leadership
Maintain knowledge of clinical documentation and charge-related regulations
Manage complex projects and investigate and analyze issues
Complete or attend assigned training and education sessions

Requirements

What you’ll need

Knowledge in Emergency Department charging
More than 2 years of RN experience
Licensed Registered Professional Nurse (RN) with the Illinois Department of Financial and Professional Regulation (IDFPR)
Bachelor's Degree in Nursing
Knowledge of clinical documentation standards and charge-related regulations and standards
Knowledge of coding, regulatory, and payer policy guidelines
Strong attention to detail
Ability to manage large complex projects and investigate/analyze issues at a high level

Benefits

Comp & perks

Comprehensive benefits package
Remote position
Flexible M-F schedule (8a-5p)
No weekend requirements
No holiday requirements
No on-call requirements
Equal Opportunity Employer