Clinical Auditor RN - Hybrid

Clinical Auditor RN - Hybrid at Baylor Scott & White Health

Here at Baylor Scott & White Health we promote the well‑being of all individuals, families, and communities. Baylor Scott & White is the largest not‑for‑profit healthcare system in Texas that empowers you to live well.

• Eligibility on day 1 for all benefits
• Dollar‑for‑dollar 401(k) match, up to 5%
• Debt‑free tuition assistance
• Immediate access to time off benefits
• Note:
  
  Benefits may vary based on position type and/or level

As a Clinical Auditor RN, you will perform charge capture accuracy audits by reviewing and analyzing clinical documentation from the Electronic Health Record (EHR) compared to patient charges and bills. The audits review for overcharges, undercharges, or inappropriate charges across multiple audit programs, covering both hospital/technical charges and professional/provider charges.

• Hybrid position
• Must live in BSWH Service area (Dallas preferred); onsite for training and specific projects/events

• Manage planning, organizing, and executing audit tasks in clinical departments/functions.
• Evaluate clinical documentation for compliance, meeting all regulations stipulated by federal and state agencies as well as third‑party payers.
• Look for opportunities to enhance performance and provide counsel to the Revenue Integrity team and/or clinical departments/functions.
• Document and track audit findings for account corrections and issue identification and mitigation.
• Summarize audit results in a clear and concise manner.
• Propose actions aimed at improving internal controls and boosting operational efficiency and effectiveness.

• Nursing experience in an acute care hospital and/or outpatient clinic setting with general knowledge of all nursing/medicine specialties and related workflows.
• Ability to accurately examine, interpret, and understand clinical documents or medical records.
• Ability to evaluate clinical documentation compared with medical charging and billing to determine if accounts have been charged appropriately, and make recommendations for charge corrections.
• Comfortable working alone and in a team; self‑motivated, problem‑solver in a fast‑paced setting, eager to learn and grow.
• Ability to handle complex tasks through a structured, detail‑oriented, and organized manner.
• Comfortable providing training and education related to clinical issues as necessary.
• Excellent communication skills to initiate executive‑level correspondences that are clear, concise, and free of grammatical inaccuracies.
• Strong working knowledge of Microsoft Office Suite, particularly Excel, Word, PowerPoint, and Outlook.
• Bachelor's degree preferred.
• 5‑10+ years of experience in multiple hospital and/or outpatient settings, strongly preferred.
• Must live within Baylor Scott & White service area (ideally in DFW Metroplex).

• Bachelor's degree or having four years of work experience.
• At least 2 years of relevant work experience.
• Registered Nurse License.

We believe that all people should feel welcomed, valued and supported, and that our workforce should be reflective of the communities we serve.

Mid‑Senior level

Full‑time

Accounting/Auditing and Finance

Hospitals and Health Care