Itemized Bill Review Auditor III

. Review medical records to verify services were provided as billed for Hospital Bill Audit reviews .

Posted 10/24/2026full-timeRemote • United StatesMid-LevelSenior💰 $70,000 - $90,000 per yearWebsite

Key responsibilities & impact

Review medical records to verify services were provided as billed for Hospital Bill Audit reviews
Identify overcharges, undercharges and unbundled items
Identify unbundled items on itemized bills according to payer unbundling guidelines and provide references and rationale for findings
Maintain timely communication with the Audit Coordinator regarding scheduling, completion and submission of audits
Manage audit inventory and schedule audits by contacting providers to arrange dates and times
Make travel arrangements for onsite audits in accordance with EXL travel policy
Report audit-process problems to the Manager for resolution
Conduct all functions in accordance with company compliance, information security and regulatory policies

What you’ll need

Minimum of 5+ years of acute care clinical experience in medical/surgical units
Licensed Nurse with current active license
Minimum of 3+ years of hospital bill auditing experience on high-dollar claims paid at percent of billed charge, payer or provider side
CPC, CCS or CMAS desired
Excel proficiency
Familiarity with basic data entry tasks
Excellent interpersonal and communication skills
Ability to prioritize tasks and work independently
Knowledge of hospital bill auditing, payer-specific unbundling guidelines, industry standards and Medicare guidelines
Strong clinical experience and technical skills
Flexibility for independent scheduling and possible travel to provider locations
Must comply with HIPAA and other patient-information confidentiality regulations

Comp & perks

Competitive benefit package including medical, dental, vision and 401(k) plan
Exciting, fast-paced and innovative environment
Opportunity to work closely with highly experienced healthcare consultants
Opportunities to learn client business aspects, teamwork and time-management skills
Further growth and development opportunities within EXL Health and beyond
Remote U.S. home office opportunity
0–10% travel may be required