Travel Nurse (RN) - Quality Assurance

Pre-employment modules may be required for this role. Please upload any certifications or health documents you have to your profile to expedite your on-boarding process.

Additional Details:

Required Skills/Experience:

• Must have 6 years experience in a healthcare-related clinical, administrative, financial, or compliance role.

Preferred Skills/Experience:

• Prior experience conducting clinical quality or utilization reviews or compliance audits involving federal healthcare programs such as Medicare and Medicaid highly preferred.
• Prior experience in coding, revenue cycle, Charge Description Master (CDM), or revenue integrity highly preferred.

Required Credentials:

• Bachelor's degree required.
• Healthcare coding certification required and must be maintained as a condition of continued employment; acceptable credentials include Certified Professional Coder (CPC), Certified Outpatient Coder (COC), or Certified Coding Specialist (CCS).

Preferred Credentials:

• Clinical or healthcare-related field preferred.

Unit Details:

• Compliance Nurse Auditor role focused on auditing patient medical records to ensure documentation supports the reasons for treatment, coding/billing, payment, or operations and aligns with clinical best practice, system policies and procedures, applicable regulatory requirements, and payor rules.
• Provides reports of findings with recommendations to improve documentation, coding, or billing practices, correct discrepancies, and implement corrective action to prevent reoccurrence.
• Conducts monitoring related to quality of care, patient safety, utilization management, medical necessity, and evidence-based guidelines.
• Assists with government agency and contractor audits or inquiries, helps determine refunds or repayments to federal healthcare programs, supports policy and procedure development or revision, monitors regulatory changes, and collaborates with Internal Audit, Patient Financial Services, Health Information Management, Care Management, Government Reimbursement, Regulatory and Accreditation, Clinical Research, Clinical Support Services, Legal, and UT Southwestern.
• Uses Microsoft Office applications.
• Proof of Taxable Address: Driver’s License, Current Utility Bill, Lease/Rental Agreement, Mortgage Statement/Bill, Homeowner’s or Renter’s Insurance Statement/Bill, Voter Registration, Bank Statement, Auto Insurance, Tax Return

Shift & Scheduling:

• Monday-Friday, start time between 7am-8am.
• Initial orientation will require more on-site days for onboarding; a specific schedule can be negotiated with the individual.
• After onboarding, periodic on-site work is needed with a hybrid/flexible schedule.
• No call.
• No weekends