The Revenue Cycle Clinical Nurse Auditor leverages clinical knowledge and documentation review to ensure appropriate charge capture and revenue optimization
Job Summary
The Revenue Cycle Clinical Nurse Auditor leverages clinical knowledge and documentation review to ensure appropriate charge capture and revenue optimization.
This role involves utilizing Epic technology and analytics to identify revenue integrity trends and investigate areas of revenue leakage.
The position requires collaboration with clinical teams, compliance, and other departments to provide education and maximize system efficiency for timely charge capture.
Matching Summary
The Revenue Cycle Clinical Nurse Auditor leverages clinical knowledge and documentation review to ensure appropriate charge capture and revenue optimization.
Skills & Requirements
Must-have
Valid Texas RN License
5+ years utilization review experience
Epic billing system proficiency
ICD-10 diagnosis code knowledge
CMS Medicare Part A B C billing requirements
Nice-to-have
Viseo software experience preferred
MCG evidence-based screening guidelines
Strong analytical and process mapping skills
Excellent communication and interpersonal skills
Ability to work cross-functionally with IT
Key Requirements
Bachelor's degree in nursing from accredited college
Valid Texas RN License or eligible Compact License
5+ years experience in utilization review and clinical review
Knowledge of CMS Medicare billing requirements
Experience with national evidence-based screening guidelines