Nurse Auditor

University Medical Center of Southern Nevada Position Summary Responsible for conducting hospital bill charge audits by reviewing medical records to verify services were provided and charges are appropriate, identifying overcharges, undercharges, and unbundled items per carrier contract and industry standards. Job Requirements Education/Experience: Graduation from an accredited school of nursing; three (3) years’ experience in clinical nursing; and two (2) years of utilization management or other chart auditing experience. Licensing/Certification Requirements: Valid state license as a Registered Nurse. Additional Position Requirements Experience submitting Nevada Medicaid Authorization Requests Knowledge of CMS Coding/Billing requirements EPIC Experience Previous Utilization Management Experience Experience in Chart Auditing Experience in developing denial appeal responses Knowledge, Skills, Abilities, and Physical Requirements Knowledge of: Medical review, chart audits, and quality improvement processes; compliance regulations related to documentation, coding, and billing; clinical pathways, disease state management, and utilization review criteria; Medicare/Medicaid guidelines; HIPAA Privacy and Security Rules; auditing concepts; reviewing medical records and coding documents; department and hospital safety practices; patient rights; age-specific patient care practices; infection control policies; handling hazardous materials; emergency response policies. Skills in: Analyzing and evaluating medical information; reviewing and verifying accuracy of data; applying clinical review guidelines; independent judgment within policy; multi-tasking in a fast-paced environment; preparing clear reports; using computers; communicating with diverse populations; establishing working relationships; safe use of equipment. Physical Requirements and Working Conditions: Mobility to work in an office setting and use standard equipment; stamina to remain seated; vision to read printed materials and VDT screen; hearing and speech for communication; ability to lift up to 10 pounds occasionally; may work shifts and weekends. Reasonable accommodations may be made. Benefits Employer Paid Pension Plan through Nevada Public Employees' Retirement System (PERS). Vesting after 5 years of qualifying employment. Health/Dental/Vision Insurance – less than $20 per paycheck for employee-only coverage. Consolidated Annual Leave (CAL) – used for personal leave, holidays (12 scheduled per year), doctor appointments, vacation, and sick days up to 16 consecutive hours. Extended Illness Bank (a/k/a Sick Bank). 457 Deferred Compensation Plan. Comprehensive Group Health Insurance Plan. Nevada has no State Income Tax. No Social Security (FICA) Deduction. THE UNIVERSITY MEDICAL CENTER OF SOUTHERN NEVADA IS AN AFFIRMATIVE ACTION/ EQUAL OPPORTUNITY EMPLOYER Closing Date/Time: 6/23/2026 5:00 PM Pacific #J-18808-Ljbffr