Temp - Registered Nurse (RN) - Compliance Auditor (Days) Dallas, TX

Title: Temp - Registered Nurse (RN) - Compliance Auditor (Days) Dallas, TX

Description: Candidates living within 60 miles of the facility will have a local rate of $72

Monday-Friday, start time between 7am-8am. The initial orientation will require more on-site days for onboarding, but a specific schedule can be negotiated with the individual. After onboarding, periodic on-site is needed, but we can accommodate a hybrid/flexible schedule!


The Compliance Nurse Auditor is responsible for
conducting audits to ensure the clinical
documentation contained within the patient medical
record supports the reasons for treatment, coding/billing, payment or
operations. Audits are designed to ensure accuracy
of content and compliance with clinical best practice,
system policies and procedures and applicable regulatory requirements and payor
rules. The Nurse Auditor provides reports of findings, including
recommendations to improve documentation, coding or billing practices, correct
discrepancies discovered and implement corrective action to prevent reoccurrence.

Skills or Special
Abilities:

• Advanced computer
  skills and proficient with Microsoft Office
  applications.
• Detailed knowledge
  of compliance program
  requirements for hospitals
  and academic health systems.
• Demonstrates
  the ability to evaluate healthcare compliance issues and make appropriate
  recommendations. Special focus on compliance matters involving quality
  of care, patient
  safety, utilization management, medical necessity and evidence-based
  guidelines.
• Demonstrates the ability to accurately and timely audit and reconcile patient medical records
  and financial accounts.Strong
  oral and written communication skills and interpersonal skills. Able to
  communicate thoughts, ideas, information and messages with clear language,
  style, organization and format
  appropriate to the subject matter, purpose and audience.
• Possesses excellent critical thinking skills,
  including the ability
  to identify a problem, determine
  the root-cause, communicate findings and participate in the development
  of the solution.
• Detail-oriented with strong organizational and time management skills and the ability to effectively prioritize daily tasks.
• Capable of managing difficult
  conversations with sensitivity and the ability
  to respond to confidential information with
  objectivity and discretion.
• Demonstrates a high degree of integrity and practice ethical
  standards.

Responsibilities

• Conducts audits of patient
  medical records to ascertain whether the care provided is properly documented
  in support of clinical best practice(s) and evidence-based guidelines and
  accurately reflects the items
  and services included
  in the financial account (i.e.,
  on the bill or claim).
  Provides detailed reports and develops corrective action plans to correct discrepancies identified during theaudit process.
• Explicitly and concisely document
  clinical and charge-audit findings in a way that can be easily
  understood by non-clinical personnel.
• With
  a focus on quality of care, patient safety and appropriate revenue integrity
  practices, conducts routine monitoring in an effort to prevent, detect and
  respond appropriately to compliance risks. Consults
  with management to report findings
  and provide corrective action recommendations.
• Conducts thorough
  research and provides
  prompt, courteous consultative services regarding
  compliance matters.
• Assists in monitoring and responding to audits and/or inquiries from government agencies
  and their contractors.
• Provides clinical
  knowledge as needed to help the department determine whether to make
  refunds/repayments to Federal healthcare programs.
• Assists with the development of new, or revisions of, existing policies
  and procedures, as warranted, based upon regulatory developments and compliance monitoring and auditing activities/findings.
• Monitors changes
  in laws and regulations related
  to compliance and communicates changes
  to appropriate personnel.
• Collaborates with personnel
  across Parkland particularly in the Internal
  Audit, Patient Financial Services, Health Information
  Management, Care Management, Government Reimbursement, Regulatory and
  Accreditation, Clinical Research, Clinical Support Services, and Legal
  Departments, and with representatives of UT Southwestern.