• Nurse Auditor

    Actalent (West Des Moines, IA)


    Job Title: Nurse Auditor Job Description

     

    This role requires a thorough understanding of standard medical coding, including CPT, ICD-10, and HCPCS. The Nurse Auditor is responsible for adjudicating claims to comply with client contracts and plan documentation. This includes determining accurate payment criteria for pending claims, auditing and pricing a wide variety of claim types, and ensuring compliance with departmental and company policies.

    Responsibilities

    + Adjudicate claims to maintain and comply with client contracts and plan documentation.

    + Determine accurate payment criteria for clearing pending claims based on defined policies and procedures.

    + Audit and price a wide variety of claim types.

    + Identify claims with inaccurate data or claims that require review by appropriate team members.

    + Maintain productivity work task goals, quality standards, and aging timeframes.

    + Contribute positively as a team player.

    + Complete special projects as assigned.

    + Comply with all departmental and company policies and procedures.

    + Research unclear and unusual claims.

    Essential Skills

    + Registered Nurse (RN) license required.

    + 3+ years of experience in medical record review, billing, and auditing with extensive knowledge of medical coding and/or Medicare Guidelines.

    + Strong problem-solving skills and ability to work independently.

    Additional Skills & Qualifications

    + Medical Coding licensure preferred; open to candidates actively pursuing certification such as CPC, CIC, COC, CPMA, or AHIMA.

    Work Environment

    The position is based in Iowa with a hybrid schedule of 3 days in-office and 2 days remote. The work hours are Monday to Friday, 8 AM to 5 PM, with a flexible start time between 6 AM and 8 AM. The team consists of 7 members with a combined 250+ years of expertise across dialysis, surgery, coding, and billing. The company is located in a newly renovated building in West Des Moines, featuring on-site amenities like a basketball court, pickleball court, arcade, and café. The culture is focused on collaboration and employee well-being. The role requires initial training for one week in-person at the West Des Moines office.

     

    Job Type & Location

     

    This is a Permanent position based out of West Des Moines, Iowa.

    Pay and Benefits

    The pay range for this position is $75000.00 - $100000.00/yr.

     

    Insurance Coverage: Health, dental, vision, disability, and life insurance plans.Retirement Savings: 401(k) plan to help you plan for the future.Flexible Spending Accounts (FSA): Options available for healthcare and dependent care expenses.Leave Programs: Bereavement, parental, family, and medical leave to support life’s important moments.Adoption Assistance: Financial support for employees expanding their families through adoption.Paid Holidays:New Year’s DayMartin Luther King Jr. DayMemorial DayIndependence DayLabor DayThanksgiving DayDay After ThanksgivingChristmas Eve (½ day)Christmas DayNew Year’s Eve (½ day)Paid Time Off (PTO):Full-time employees accrue up to 4.62 hours of PTO per pay period, totaling up to 120 hours annually.After three consecutive years of full-time employment, accrual increases to 6.154 hours per pay period.

     

    Workplace Type

     

    This is a hybrid position in West Des Moines,IA.

     

    Application Deadline

     

    This position is anticipated to close on Sep 16, 2025.

    About Actalent

    Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.

     

    The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

     

    If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing due to a disability, please email [email protected] (%[email protected]) for other accommodation options.