What are the responsibilities and job description for the Nurse Auditor - Revenue Cycle Patient Accounts position at UTMB Health?
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 :
RNdesignationwithcurrentTexaslicenserequired.Minimumoftwoyearsexperienceindirectpatientcare inhospitalsetting.
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.
