Nurse Auditor - Clinical Billing Edits

Texas Health Resources; Arlington (TX); Remote; USD 60,000 - 90,000; Full time

Job summary

Join a forward-thinking healthcare organization as a Nurse Auditor, where your clinical expertise will enhance billing accuracy and compliance. In this remote role, you will analyze clinical documentation to ensure appropriate billing practices while collaborating with a supportive team. Enjoy a comfortable work-from-home environment with opportunities for ongoing training and career growth. Benefit from a comprehensive package including medical, dental, and tuition reimbursement. This is a chance to make a meaningful impact in patient care while advancing your professional journey.

Benefits

401k

PTO

Medical Insurance

Dental Insurance

Paid Parental Leave

Tuition Reimbursement

Student Loan Forgiveness

Qualifications

• 5 years of clinical experience required for the role.
• Strong knowledge of Medicare billing guidelines needed.

Responsibilities

• Analyze billing edits for compliant service billing.
• Provide education and feedback to improve documentation.

Skills

Clinical Analysis

Billing Methodology

Revenue Cycle Management

Communication Skills

Education

Associate's Degree in Nursing

Texas RN License

Job description

**Nurse Auditor – Clinical Billing Edits**

_Bring your passion to Texas Health so we are Better + Together_

**Work location:** Remote

**Work hours:** Monday – Friday from 8:30am – 5pm

**Department highlights:**

+ Opportunity for career growth: expand knowledge base of revenue and business operations

+ Comfortable, supportive work from home environment with supportive team

+ Ongoing training and development including Medicare billing guidelines and select aspects of coding

+ Small team with strong, collaborative relationships

**Here’s What You Need**

+ Associate’s Degree in Nursing required

+ 5 years clinical experience required

+ Revenue Cycle experience strongly preferred

+ Texas RN upon hire required

**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 Texas Health Nurse Auditor – Clinical Billing Edits**

+ Benefits include 401k, PTO, medical, dental, Paid Parental Leave, flex spending, tuition reimbursement, student Loan forgiveness as well as several other benefits.

+ Delivery of high quality of patient care through nursing education, nursing research and innovations in nursing practice.

+ Strong Unit Based Council (UBC).

+ A supportive, team environment with outstanding opportunities for growth.

+ Learn (https://jobs.texashealth.org/why-texas-health/) more about our culture, benefits, and recent awards.

**_Do you still have questions or concerns?_** Feel free to email your questions to [e-mail] .

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Texas Health requires a resume when an application is submitted.Employment opportunities are only reflective of wholly owned Texas Health Resources entities.

We are an Equal Opportunity Employer and do not discriminate against any employees or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.