Nurse Auditor - Revenue Cycle Patient Accounts

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 a hospital setting. Major Duties/Critical Tasks: • Reviews and investigates denials from third-party payers that have clinical implications. • Uses medical records and clinical expertise to appeal denials with payers for payment. • Conducts defense audits of patient account charges with outside auditing firms to ensure revenue integrity. • Responds to inquiries from patients, carriers and departments within UTMB regarding explanation and validity of patient account charges. • Respond to inquiries from patients, carriers and departments within UTMB regarding expected charges for specific items and procedures using state-of the-art computing system, contact with service areas of hospital and department database. • Adheres to internal controls established for department. • Performs related duties as required 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 Federal Contractor, UTMB Health takes affirmative action to hire and advance protected veterans and individuals with disabilities. • ! For application assistance, please email [email protected] Representatives are available Monday through Friday from 8 a.m. to 5 p.m. CST. Apply tot his job Apply To this Job