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AUDITOR/RN

Texoma Medical Center Denison Full-Time
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One of the nation’s largest and most respected hospital companies, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Steadily growing from a startup to an esteemed Fortune 500 corporation, UHS today has annual revenue nearing $10 billion. In 2017, UHS was recognized as one of the World’s Most Admired Companies by Fortune; ranked #276 on the Fortune 500, and listed #275 in Forbes inaugural ranking of America’s Top 500 Public Companies.

Our operating philosophy is as effective today as it was 40 years ago: Build or acquire high quality hospitals in rapidly growing markets, invest in the people and equipment needed to allow each facility to thrive, and become the leading healthcare provider in each community we serve.

Headquartered in King of Prussia, PA, UHS has more than 81,000 employees and through its subsidiaries operates more than 320 acute care hospitals, behavioral health facilities and ambulatory centers in the United States, Puerto Rico, the U.S. Virgin Islands and the United Kingdom.

Texoma Medical Center, a 403-bed acute care facility has been providing quality health care to the residents of North Texas and Southern Oklahoma since 1965. Our main campus is located in Denison, Texas, approximately one hour north of the Dallas/Fort Worth area and just south of the Texas/Oklahoma border. In addition, we have numerous facilities in locations throughout the Texoma region.

Since 1965, TMC has forged a special relationship with the people of North Texas and Southern Oklahoma. Texoma residents have come to depend on TMC to meet a spectrum of physical, mental and spiritual needs. TMC has responded with unique services to provide the kind of sophisticated, experienced care that was once was available only in major metropolitan areas.

We offer major specialty services including open heart surgery and neurosurgery. Advanced resources such as certified trauma care support TMC's role as a regional specialty center.

Position Summary:  The primary responsibility of the Revenue Integrity/Nurse Auditor is to monitor clinical activities related to billing compliance.  This position acts as a liaison between the facility and the Centralized Business Office.  This position must have the ability to work effectively with payers, patients, clinicians, Health Information Management and other employees.

Job Requirements

Current RN licensure in the State of Texas.

Three-five years' work experience in clinical inpatient nursing, case or utilization management. Three-five years' experience with charge capture auditing, clinical documentation integrity or similar role for a complex acute care institution.

Broad knowledge of health care and/or hospital business office practices and priniciples. Knowledge of third party payer practices including precertification, filing deadlines, claims processing, coverage issues and referral requirements. Knowledge and understanding of state and federal rules and regulations related to Medicare and Medicaid, laws regarding confidentiality, compliance, release of information and insurance regulations. Must possess effective organizational planning, scheduling and project management skills. Must possess effective communication skills, both written and oral, with a communication style that is open and fosters trust, credibility and understanding. Strong customer service skills that ensure a high level of customer satisfaction and promotes collaborative alliances and teamwork. Effective analytical ability in order to develop and analyze options, recommend solutions and solve complex problems and issues. Proficiency in Microsoft Office applications and others as required. 

 

Recommended skills

Claims
Medicaid
Scheduling
Medicare
Communication
Utilization Management
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Job ID: 78154

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Texoma Medical Center (TMC) is an acute care hospital with a medical staff of more than 200 physicians. The main campus is located in Denison, Texas, approximately one hour north of the Dallas/Fort Worth metroplex and just south of the Texas/Oklahoma border. In addition, Texoma Medical center operates a number of locations throughout the Texoma region.

The hospital offers major specialty services, including open heart surgery and neurosurgery. Advanced resources, such as certified trauma care support TMC's role as a regional specialty center.

Since 1965, TMC has forged a special relationship with the people of North Texas and Southern Oklahoma. Texoma residents have come to depend on TMC to meet a spectrum of physical, mental and spiritual needs. TMC has responded with unique services to provide the kind of sophisticated, experienced care that was once available only in major metropolitan areas.

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