Nurse Auditor

Here’s What You Need
• Associate’s degree in Nursing required 
• 5 years clinical experience required 
• Appeals/Denials experience preferred 
• Charging experience preferred 
• CPT coding experience preferred 
• RN upon hire preferred

What You Will Do

In this position, the auditor analyzes issues from service department personnel charge entry, billing department edits, and provides correct billing methodology instruction based on clinical analysis.  The position provides leadership, physicians, and clinicians with education and feed-back to improve charging documentation and utilization management based on Medicare guidelines.

• Analyze billing edits that require clinical documentation review in order to determine appropriate, compliant billing of services with application of modifiers, corrections to charges or other billing actions as deemed appropriate. Complete billing edit work queues involved with clinical analysis. Performs audits of patient accounts against the medical records to ensure patient bill reflects services received.
• Provide communication and education regarding charge issues/corrections as appropriate to entities.  Report charge issues to management when appropriate and assist in the reconciliation of these issues.  Communicate collaborate with CBO billing staff as needed to ensure compliant billing. Assist billing department in decision-making by clinical analysis of “relatedness” to inpatients, liability, and ESRD.  Trend and report charge issues when appropriate to management and assist in the reconciliation of these issues.
• Complete audit worksheets, education log and any other required forms reflecting actions taken to accounts and identified issues.
• Serve on special projects as deemed necessary. Assist in problem resolution.  

Additional perks of being a Nurse Auditor

• Benefits include 401k, PTO, medical, dental, Paid Parental Leave, flex spending, tuition reimbursement, Student Loan Repayment Program as well as several other benefits.
• At Texas Health, our people make this a great place to work every day. Our inclusive, supportive, people-first, excellence-driven culture make Texas Health a great place to work.
• A supportive, team environment with outstanding opportunities for growth.
 
We invite you to join us in furthering your career through our accomplishments and philosophy of excellence.
Learn more about our culture, benefits, and recent awards.

Do you still have questions or concerns? Feel free to email your questions to recruitment@texashealth.org.

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