Nurse Auditor, Days, (OR exp is required)

At Houston Methodist, the Nurse Auditor position is responsible auditing and reconciling patient charts (i.e. medical record) on a daily basis or upon request from Payor's on-site auditors, Patient Accounting, Risk Management, Revenue Cycle, and other hospital entities needing completion of audit for reasons of treatment, payment or operations to ensure accuracy and in compliance with regulatory requirements, hospital and system policies and procedures. This position will complete audits to ensure that the clinical documentation contained within the patient chart supports items and services included on the patient bill and identifies and corrects errors or discrepancies to accurately support reasons for treatment, billing, payment or operations. The Nurse Auditor position ensures clinical documentation supports all patient billing, verifies all patient services are listed for payment, prepares reports of discrepancies/exceptions and provides recommendations for corrective action. This position ensures complete and timely responses to requests from hospital, other Houston Methodist entities, and Corporate for additional needed information, or further audits. The Nurse Auditor position responds to audits in the form of verbal exit conferences and/or a written exchange of findings.

Requirements:

Qualifications:

LICENSES AND CERTIFICATIONS - REQUIRED

• RN - Registered Nurse - Texas State Licensure and/or Compact State Licensure within 60 days OR
• RN-Temp - Registered Nurse - Temporary State Licensure within 60 days

KNOWLEDGE, SKILLS, AND ABILITIES

• Demonstrates the skills and competencies necessary to safely perform the assigned job, determined through on-going skills, competency assessments, and performance evaluations

• Sufficient proficiency in speaking, reading, and writing the English language necessary to perform the essential functions of this job, especially with regard to activities impacting patient or employee safety or security

• Ability to effectively communicate with patients, physicians, family members and co-workers in a manner consistent with a customer service focus and application of positive language principles

• Ability to learn and apply use of databases for aggregation of data for analysis

• Ability to independently analyze and solve problems

• Computer proficiency to complete job duties independently

• Expertise in medical staff quality initiatives

• Strong research interpretation skills

• Time management and prioritization skills

• Flexibility and ability to adapt to change

SUPPLEMENTAL REQUIREMENTS

WORK ATTIRE

• Uniform No
• Scrubs Yes
• Business professional Yes
• Other (department approved) Yes

ON-CALL*
*Note that employees may be required to be on-call during emergencies (ie. DIsaster, Severe Weather Events, etc) regardless of selection below.

• On Call* No

TRAVEL**
**Travel specifications may vary by department**

• May require travel within the Houston Metropolitan area Yes
• May require travel outside Houston Metropolitan area Yes

Company Profile:

Houston Methodist West Hospital is committed to leading medicine in West Houston, Katy and surrounding communities by delivering the Houston Methodist standard of exceptional safety, quality, service and innovation. The growing campus offers 253 beds and access to the most innovative medical and surgical care available, including cardiology and cardiovascular surgery; neurology and neurosurgery; comprehensive cancer care; orthopedics and sports medicine; gastroenterology; bariatrics; childbirth center with level III NICU; emergency care; and advanced imaging.

Houston Methodist is an Equal Opportunity Employer.

Equal employment opportunity is a sound and just concept to which Houston Methodist is firmly bound. Houston Methodist will not engage in discrimination against or harassment of any person employed or seeking employment with Houston Methodist on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, status as a protected veteran or other characteristics protected by law. VEVRAA Federal Contractor – priority referral Protected Veterans requested.