Blue Cross Rn Remote Jobs in Forney, TX (NOW HIRING)

Project Audit RN

Full Time, Remote

WHY UT SOUTHWESTERN?
With over 75 years of excellence in Dallas-Fort Worth, Texas, UT Southwestern is committed to excellence, innovation, teamwork, and compassion. As a world-renowned medical and research center, we strive to provide the best possible care, resources, and benefits for our valued employees. Ranked as the number 1 hospital in Dallas-Fort Worth according to U.S. News & World Report, we invest in you with opportunities for career growth and development to align with your future goals. Our highly competitive benefits package offers healthcare, PTO and paid holidays, on-site childcare, wage, merit increases and so much more. We invite you to be a part of the UT Southwestern team where you'll discover a culture of teamwork, professionalism, and a rewarding career! 
 

JOB SUMMARY

The Revenue Integrity Project Audit Nurse plays a dual, highly impactful role supporting both clinical audit operations and strategic revenue integrity initiatives. This position blends traditional audit responsibilities with project coordination, data analysis, education, and workflow optimization to support sustainable charge capture accuracy and compliance across hospitalbased and outpatient settings.

The ideal candidate is an experienced auditor with strong clinical knowledge who is equally comfortable tackling crossfunctional projects, partnering with clinical and informatics teams, and translating audit findings into actionable improvements. 

BENEFITS
UT Southwestern is proud to offer a competitive and comprehensive benefits package to eligible employees. Our benefits are designed to support your overall wellbeing, and include:

• PPO medical plan, available day one at no cost for full-time employee-only coverage
• 100% coverage for preventive healthcare-no copay
• Paid Time Off, available day one
• Retirement Programs through the Teacher Retirement System of Texas (TRS)
• Paid Parental Leave Benefit
• Wellness programs
• Tuition Reimbursement
• Public Service Loan Forgiveness (PSLF) Qualified Employer
• Learn more about these and other UTSW employee benefits!

EXPERIENCE AND EDUCATION
Required

• Education
  Graduate of an accredited nursing program. 
   

• Experience
  5 years of clinical experience as a RN including 
  2 years performing utilization review, charge audit, case management or denial/appeal functions in an acute care hospital. 
  Principles of Managed Care, Medicare/Medicaid reimbursement. 
   

• Licenses and Certifications
  (RN) REGISTERED NURSE Upon Hire 
   

Preferred

• Experience: 

At least 2 years of experience in project management, project coordination, or production coordination within a healthcare or revenue cycle environment

• License and Certifications

Lean Six Sigma certification (Yellow Belt or higher preferred)

Revenue Integrity certification, coding credential (CPC, CCS), or audit certification preferred 
 

JOB DUTIES

• Perform project management activities in accordance with established project management principles, including executing assigned tasks outlined in approved project plans
• Support project execution through basic process analysis, task coordination, and issue tracking
• Assist Project Manager(s) in completing projects within defined scope, timeline, and objectives
• Conduct postproject reviews and prepare recommendations to identify successful outcomes, gaps, and opportunities for improvement
• Build, maintain, and strengthen relationships essential to successful project outcomes
• Collaborate with internal partners including Health Information Management, clinical nursing units, physicians, clinical informatics, and other departments to obtain information, resolve errors, and address audit trends
• Create, maintain, and organize comprehensive project documentation, including plans, status updates, and supporting materials
• Develop professional correspondence and provide administrative and editorial support for special projects, including presentations, meetings, and conferences; conduct internet and background research as needed
• Conduct clinical and billing audits by comparing medical record documentation to charges billed to identify potential undercharges, overcharges, or billing errors
• Document audit findings, post account corrections when appropriate, and communicate results to impacted departments
• Assist departments with charge reconciliation processes and provide timely education related to documentation, charging accuracy, and process improvement
• Perform other duties as assigned 

SECURITY AND EEO STATEMENT
Security
This position is security-sensitive and subject to Texas Education Code 51.215, which authorizes UT Southwestern to obtain criminal history record information.
EEO
UT Southwestern Medical Center is committed to an educational and working environment that provides equal opportunity to all members of the University community. As an equal opportunity employer, UT Southwestern prohibits unlawful discrimination, including discrimination on the basis of race, color, religion, national origin, sex, sexual orientation, gender identity, gender expression, age, disability, genetic information, citizenship status, or veteran status.