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UTMB Health Nurse Auditor - Revenue Cycle Patient Accounts in Galveston, Texas

Nurse Auditor - Revenue Cycle Patient Accounts

Galveston, Texas, United States

New Hot

Business, Managerial & Finance

UTMB Health

Requisition # 2500700

Job Description:

To provide clinical / technical support for the department through investigating denials, responding to inquiries regarding revenue integrity, performing defense audits, and responding to procedural / cost inquiries.

Required Education/Experience:

RN designation with current Texas license required. Minimum of two years experience in direct patient care in hospital setting.

Major Duties/Critical Tasks:

  • Reviewsandinvestigatesdenialsforpaymentfromthird-partypayersthathaveclinicalimplications.Usesmedicalrecordsandclinicalexpertisetoappealdenialswithpayersforpayment.

  • Conductsdefenseauditsofpatientaccountchargeswithoutsideauditingfirmstoensurerevenueintegrity.

  • Respondstoinquiriesfrompatients,carriersanddepartmentswithinUTMBregardingexplanation andvalidityofpatientaccountcharges.

  • Respondstoinquiriesfrompatients,carriersanddepartmentswithinUTMBregardingexpectedchargesforspecificitemsandproceduresusingstate-of the-artcomputingsystem,contactwithserviceareasofhospitalanddepartmentdatabase.

  • Adherestointernalcontrolsestablishedfordepartment.

  • Performsrelateddutiesasrequired.

Salary Range:

Actual salary commensurate with experience.

Equal Employment Opportunity

UTMB Health strives to provide equal opportunity employment without regard to race, color, religion, age, national origin, sex, gender, sexual orientation, gender identity/expression, genetic information, disability, veteran status, or any other basis protected by institutional policy or by federal, state or local laws unless such distinction is required by law. As a VEVRAA Federal Contractor, UTMB Health takes affirmative action to hire and advance women, minorities, protected veterans and individuals with disabilities.

Compensation

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