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

Title: Temp - Registered Nurse (RN) - Compliance Auditor (Days) Dallas, TXDescription: Candidates living within 60 miles of the facility will have a local rate of The Compliance Nurse Auditor is responsible forconducting audits to ensure the clinicaldocumentation contained within the patient medicalrecord supports the reasons for treatment, coding/billing, payment oroperations. Audits are designed to ensure accuracyof content and compliance with clinical best practice,system policies and procedures and applicable regulatory requirements and payorrules. The Nurse Auditor provides reports of findings, includingrecommendations to improve documentation, coding or billing practices, correctdiscrepancies discovered and implement corrective action to prevent reoccurrence.Skills or SpecialAbilities:

• Advanced computerskills and proficient with Microsoft Officeapplications.
• Detailed knowledgeof compliance programrequirements for hospitalsand academic health systems.
• Demonstratesthe ability to evaluate healthcare compliance issues and make appropriaterecommendations. Special focus on compliance matters involving qualityof care, patientsafety, utilization management, medical necessity and evidence-basedguidelines.
• Demonstrates the ability to accurately and timely audit and reconcile patient medical recordsand financial accounts.Strongoral and written communication skills and interpersonal skills. Able tocommunicate thoughts, ideas, information and messages with clear language,style, organization and formatappropriate to the subject matter, purpose and audience.
• Possesses excellent critical thinking skills,including the abilityto identify a problem, determinethe root-cause, communicate findings and participate in the developmentof the solution.
• Detail-oriented with strong organizational and time management skills and the ability to effectively prioritize daily tasks.
• Capable of managing difficultconversations with sensitivity and the abilityto respond to confidential information withobjectivity and discretion.
• Demonstrates a high degree of integrity and practice ethicalstandards.

Responsibilities

• Conducts audits of patientmedical records to ascertain whether the care provided is properly documentedin support of clinical best practice(s) and evidence-based guidelines andaccurately reflects the itemsand services includedin 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 documentclinical and charge-audit findings in a way that can be easilyunderstood by non-clinical personnel.
• Witha focus on quality of care, patient safety and appropriate revenue integritypractices, conducts routine monitoring in an effort to prevent, detect andrespond appropriately to compliance risks. Consultswith management to report findingsand provide corrective action recommendations.
• Conducts thoroughresearch and providesprompt, courteous consultative services regardingcompliance matters.
• Assists in monitoring and responding to audits and/or inquiries from government agenciesand their contractors.
• Provides clinicalknowledge as needed to help the department determine whether to makerefunds/repayments to Federal healthcare programs.
• Assists with the development of new, or revisions of, existing policiesand procedures, as warranted, based upon regulatory developments and compliance monitoring and auditing activities/findings.
• Monitors changesin laws and regulations relatedto compliance and communicates changesto appropriate personnel.
• Collaborates with personnelacross Parkland particularly in the InternalAudit, Patient Financial Services, Health InformationManagement, Care Management, Government Reimbursement, Regulatory andAccreditation, Clinical Research, Clinical Support Services, and LegalDepartments, and with representatives of UT Southwestern.