RN Auditors are responsible for evaluating the accuracy of patient care and comparing it to clinical documentation. To uphold legal and internal standards, RN Auditors must inspect a series of documents for each patient in a facility, including insurance and billing charts.
- Audits medical charts and patient documents for accuracy
- Records billing discrepancies and reports to higher management
- Compares medical codes to clinical treatment given
- Ensures patient treatment charges are correctly billed
- Partners cross-functionally to improve financial and administrative systems
Qualifications and Skills
- High School Diploma or GED
- Associate’s Degree in Nursing
- Bachelor’s Degree in Nursing preferred
- Active RN license in the state of employment
- 3+ years of auditing or case management experience
- 2+ years of experience in a healthcare setting
RN Auditors must possess strong verbal communication skills to effectively record and convey the needs of patients and transfer information to other departments. Computer skills are required for RN Auditors to efficiently record and transfer information across a facility. Because they must measure the accuracy and quality of care for each patient, attention to detail and extensive clinical knowledge are essential to the role of an RN Auditor.