Texas Licensed Audit Registered Nurse

Job Summary

A company is looking for a Sr. Audit RN - Revenue Integrity.

Key Responsibilities

• Monitor and conduct audits requested by payors, comparing clinical documentation to billed charges
• Develop and maintain metrics for audits, reporting findings to relevant departments
• Lead meetings with Revenue Integrity teams and assist departments with charge reconciliation processes

Required Qualifications, Training, and Education

• Graduate of an accredited nursing program with a current RN license in Texas
• 10 years of clinical experience as a Registered Nurse, including 5 to 7 years in utilization review or charge audit
• Knowledge of Principles of Managed Care and Medicare/Medicaid reimbursement
• Experience with Epic HB is preferred