Inpatient Hospital Auditor II

Horizon Blue Cross Blue Shield of New Jersey • Hopewell, NJ, US • published 2026-09-19 11:37:38.737754

Description

**Horizon Blue Cross Blue Shield of New Jersey** empowers our members to achieve their best health. For over **90 years**, we have been New Jersey’s health solutions leader driving innovations that improve health care quality, affordability, and member experience. Our members are our neighbors, our friends, and our families. It is this understanding that drives us to better serve and care for the **3\.5 million** people who place their trust in us. We pride ourselves on our best\-in\-class employees and strive to maintain an innovative and inclusive environment that allows them to thrive. When our employees bring their best and succeed, the Company succeeds. **About the Role** This position is responsible for being the lead on site audits of hospital billing and coding practices and desk audits; forms development, profiling and tracking institutional audit trends. Designing audit protocols and special projects. Performs and finalizes multiple per diem, bill verification, DRG Validation (utilization review audits) and credit balance. Additionally provides guidance/instruction to various stakeholders on ICD10\-CM, ICD10\-PCS \& DRG assignment payment and auditing.**What You'll Do** *...

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