Nurse Auditor

Nurse Auditor Role Overview

PSN Affiliates is seeking a skilled Nurse Auditor to review, audit, and report on revenue integrity with a focus on charge issues and risks at the departmental and facility level. The ideal candidate will have a thorough understanding of hospital billing, chart reviews, and coding, as well as experience with UR and Case Management, payer contract, and reimbursement rates.

Key Responsibilities

• Conduct coding audits, quality assurance assessments of claims, and reviews of statistical samples to identify risk.
• Apply nursing expertise to ensure compliance with medical policy, medical necessity guidelines, and accepted standards of care.
• Ensure that medical claims, medical records, and other documentation essential to proper billing are compliant with federal regulation, company policies, and industry standards.
• Analyze billing trends to identify areas of non-compliance and prepare regular reports on audit findings.

Requirements

• Four years of nurse auditor, billing compliance, or charge entry experience preferred.
• RN-Registered Nurse with 2 years of clinical experience.
• Great oral and written communication skills.

Benefits

• Competitive hourly rate.
• 401K, medical, PTO accrued, dental, and vision benefits.

PSN Affiliates

PSN Affiliates provides services throughout the Texas area, including El Paso, San Antonio, Austin, Plano, Fort Worth, Carrollton, Frisco, and Irving.