Top 88 Nurse auditor Jobs in Texas

Healthcare Utilization Review Specialist
Cobalt Benefits Group LLC —Houston, TX
- $57,000 - $70,000 a year
- Full-time
- Remote
- Microsoft Outlook
- Computer literacy
- Mid-level
- Health savings account
- AD&D insurance
Quick Apply
Clinical Quality Nurse Reviewer, Sr. Specialist - Prior Auth/UM- Remote
Gainwell Technologies —Texas
- $80,000 - $95,000 a year
- Full-time
- Remote
- Nursing
- RN License
- Residential
- Travel reimbursement
- Profit sharing
7d
Nurse III
Health & Human Services Comm —Harlingen, TX
- $7,532.75 - $8,886.16 a month
- Extended hours
- 18 years or older
- Nursing
- RN License
- Health insurance
- Opportunities for advancement
Quick Apply
Managed Care Utilization Review LTSS Nurse
Health & Human Services Comm —San Antonio, TX
- $5,425.33 - $7,155.75 a month
- Online Application
- Nursing
- Microsoft Outlook
- RN License
- Health insurance
- Opportunities for advancement
Quick Apply
7d
Nurse II
Health & Human Services Comm —Richmond, TX
- $6,579.41 - $7,761.50 a month
- Extended hours
- 18 years or older
- Nursing
- RN License
- Health insurance
- Opportunities for advancement
Quick Apply
11d
DRG Clinical & Coding Educator- Remote
Gainwell Technologies —Texas
- $86,000 - $115,000 a year
- Full-time
- Remote
- Nursing
- RN License
- Mid-level
- Travel reimbursement
- Profit sharing
Nurse Educator
Health & Human Services Comm —Austin, TX
- $7,532.75 - $8,886.16 a month
- Extended hours
- 18 years or older
- CPR Certification
- Nursing
- Health insurance
- Opportunities for advancement
Quick Apply
Nurse VI Chief Nurse Executive
Health & Human Services Comm —Richmond, TX
- $10,761.41 - $15,791.58 a month
- Extended hours
- 18 years or older
- Nursing
- RN License
- Health insurance
- Opportunities for advancement
Quick Apply
QMP Nurse III
Health & Human Services Comm —Plano, TX
- $6,494 - $6,800 a month
- Online Application
- Nursing
- RN License
- Public speaking
- Health insurance
- Opportunities for advancement
Quick Apply
1d
Registered Nurse Case Manager
Health & Human Services Comm —Richmond, TX
- $7,532.75 - $8,886.16 a month
- Extended hours
- 18 years or older
- Nursing
- RN License
- Health insurance
- Opportunities for advancement
Quick Apply
Charge Auditor
Baylor Medical Center at Trophy Club (10822) —Trophy Club, TX
- Full-time
- Hospital
- Medical office experience
- Microsoft Office
- Health savings account
- AD&D insurance
Clinical Review Supervisor
CorVel Corporation —Fort Worth, TX
- $77,960 - $120,368 a year
- Full-time
- Remote
- HIPAA
- Mid-level
- Supervising experience
- Health savings account
- Disability insurance
Quick Apply
3d
Hospital Bill Audit Supervisor
CorVel Corporation —Fort Worth, TX
- $76,207 - $117,662 a year
- Full-time
- Remote
- Nursing
- RN License
- 5 years
- Health savings account
- Disability insurance
Quick Apply
Chief Nurse Executive
Health & Human Services Comm —San Antonio, TX
- $10,761.41 - $15,791.58 a month
- Extended hours
- 18 years or older
- Nursing
- RN License
- Health insurance
- Opportunities for advancement
Quick Apply
Nurse III / House Supervisor
Health & Human Services Comm —Waco, TX
- $7,532.75 - $8,886.16 a month
- Extended hours
- 18 years or older
- Nursing
- Psychiatry
- Health insurance
- Opportunities for advancement
Quick Apply
2d
Nurse III - House Supervisor
Health & Human Services Comm —Terrell, TX
- $7,532.75 - $8,886.16 a month
- Extended hours
- 18 years or older
- Nursing
- Patient monitoring
- Health insurance
- Opportunities for advancement
Quick Apply
PASRR Nurse
Health & Human Services Comm —Mexia, TX
- $6,800 a month
- Online Application
- Nursing
- Skilled nursing facility
- RN License
- Health insurance
- Opportunities for advancement
Quick Apply
Licensed Vocational Nurse III
Health & Human Services Comm —Denton, TX
- $4,866.58 - $6,335.66 a month
- Extended hours
- 18 years or older
- CPR Certification
- Nursing
- Health insurance
- Opportunities for advancement
Quick Apply
Medical APRN
Health & Human Services Comm —Austin, TX
- $11,800 - $14,356 a month
- Extended hours
- 18 years or older
- Nursing
- RN License
- Health insurance
- Opportunities for advancement
Quick Apply
Psychiatric Advanced Nurse Practitioner
Health & Human Services Comm —San Antonio, TX
- $12,390 - $14,356 a month
- Extended hours
- 18 years or older
- Nursing
- Psychiatry
- Health insurance
- Opportunities for advancement
Quick Apply

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nurse auditor jobs near texas

Healthcare Utilization Review Specialist

Cobalt Benefits Group LLC -
Houston, TX

Quick Apply

Job Details

Full-time
$57,000 - $70,000 a year

Benefits

Health savings account
AD&D insurance
Paid holidays
Disability insurance
Health insurance
Dental insurance
Flexible spending account
Tuition reimbursement
Vision insurance

Qualifications

Microsoft Outlook

Full Job Description

Description:

Join our team at Company and build a meaningful career in employee benefits solutions. As a Healthcare Utilization Review Specialist, you’ll play a vital role in ensuring our clients and members receive the right care at the right time through customized, self-funded insurance programs. You’ll review claims for medical necessity, verify authorizations, and collaborate across clinical and administrative teams to support effective utilization management.

Position Summary

Reporting to the Utilization Review Manager, the Utilization Review Specialist will coordinate reviews of group renewal information, process claims for medical necessity, and determine whether authorizations are on file. Make determinations for claims processing based upon coding. This position involves interpretation of medical data, coordination of review processes, and collaboration with clinical and administrative teams to support effective utilization management. This role is ideal for detail-oriented healthcare para-professionals who want to apply their knowledge of medical terminology and insurance processes in a supportive, team-driven environment.

Key Responsibilities

Review claims in utilization review queues for medical necessity and authorization status; determine appropriate processing based on coding and plan language.
Support the daily operations of the Utilization Review department by assisting senior UR team members with case review activities.
Conduct outreach calls and collect data using established scripts, tools, and protocols, while maintaining productivity and service standards.
Process correspondence and faxes in accordance with timeliness standards; escalate to clinical team members when appropriate.
Perform clerical and administrative tasks, including scanning, document retrieval, and urgent claims processing support.
Communicate clearly, professionally, and courteously with internal and external stakeholders to resolve issues.
Provide written direction to other team members (nurses, claims auditors) to support accurate claims processing.
Maintain current knowledge of Standard Operating Procedures, member benefits, rights, and responsibilities.
Ensure compliance with BCBS Association standards and company policies.
Complete other related duties and projects as assigned.

Requirements:

(Prior training in coding, insurance, basic medical vocabulary, training or certification in these roles preferred but not required:) Medical assistant, home health aide, nursing assistant, or other similar health care para-professional training or certification.
Fluent computer skills including MS Office (Word, Excel, and Outlook) and Internet applications.
Strong reading comprehension
Self-motivated, self-directed, operates without constant guidance.
Must be able to make sound logical decisions and articulate the reasoning.

Benefits

After successfully completing a waiting period, eligible Full-time employees have access to our comprehensive benefits package, including:

Fantastic medical, dental, and vision insurance*
Twice annual employer HSA contributions, covering 50% of the HDHP plan’s annual deductible!
Company provided Basic Life and AD&D
Company paid Short-Term and Long-Term Disability**
Flexible Spending Accounts*
401(k) Retirement Plan with up to a 6% employer-match** WOW! (100% fully vested after 3 years)
10+ paid holidays
Fully Paid half day Summer Fridays
Generous paid vacation and sick time
Annual Paid Volunteer Day
Annual Tuition Reimbursement
Annual Health and Wellness Reimbursement
Lots of fun company events

*60 day waiting period**90 day waiting period

Who We Are

As a trusted third-party administrator (TPA) specializing in self-funded benefit plans, Cobalt Benefits Group (CBG) is committed to helping employers find high-quality coverage at a cost they can afford. We administer self-funded insurance benefits through our four lines of business: EBPA, Blue Benefit Administrators of Massachusetts, CBA Blue,and Great Bay Administrators. With over 30 years of experience and a dedicated team of more than 300 employees, we work collaboratively to build customized self-funded health plans, manage claim payments and disputes, and administer other specialized programs such as FSAs, HSAs, COBRA, and retiree billing. Join us as we match employers across our region with the right solutions for their employee benefit needs. To learn more about working at CBG, visit https://www.cobaltbenefitsgroup.com/careers/.

Cobalt Benefits Group is an Equal Employment Opportunity employer.

Cobalt Benefits Group participates in E-Verify to confirm the employment eligibility of all new hires.

Quick Apply

Refine Your Search

nurse auditor jobs in texas

Healthcare Utilization Review Specialist

Clinical Quality Nurse Reviewer, Sr. Specialist - Prior Auth/UM- Remote

Nurse III

Managed Care Utilization Review LTSS Nurse

Nurse II

DRG Clinical & Coding Educator- Remote

Nurse Educator

Nurse VI Chief Nurse Executive

QMP Nurse III

Registered Nurse Case Manager

Charge Auditor

Clinical Review Supervisor

Hospital Bill Audit Supervisor

Chief Nurse Executive

Nurse III / House Supervisor

Nurse III - House Supervisor

PASRR Nurse

Licensed Vocational Nurse III

Medical APRN

Psychiatric Advanced Nurse Practitioner

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