Nursing Revenue Quality Management Auditor

KabaFusion•Orlando, FL

About The Position

Are you passionate about home infusion nursing and driven by improving documentation quality, compliance, and reimbursement outcomes? We’re looking for a Nursing Revenue Quality Management Analyst to play a critical role in strengthening revenue integrity while supporting exceptional patient care across our home infusion services. This is an opportunity for a detail‑driven, analytically minded professional to help ensure nursing services are documented accurately, billed compliantly, and converted into timely revenue. In this highly collaborative role, you’ll work alongside nursing leadership and operational teams to remove barriers, improve efficiency, and directly support the financial health of patient care. The Nursing Revenue Quality Management Analyst supports revenue integrity within home infusion services by ensuring accurate, compliant nursing documentation and billing practices. This role collaborates with nursing leadership, pharmacy, revenue cycle, and compliance teams to identify documentation risks, support audits, and drive process improvement. The position plays a critical role in optimizing reimbursement and providing education to nursing administrative teams to maintain regulatory and accreditation standards.

Requirements

Associate degree in business or related field or technical experience in lieu of degree.
Minimum of 2 years of experience in auditing, billing, or relevant detail-oriented administrative.
Extensive experience with Microsoft Excel, including but not limited to Pivot Tables and Microsoft Power BI reporting required.
Strong computer knowledge and keyboarding skills; proficient knowledge with Excel reports and other systems reporting.
Ability to work independently with high degree of accuracy and speed.
Familiarity with auditing practices, office procedures and automated equipment.
Good interpersonal communication skills and pleasant telephone manner
Demonstrates good attention to detail to thoroughly review nursing visit notes, invoices, and related documentation for accuracy, completeness, and compliance with documentation standards and billing guidelines.
Demonstrates knowledge of billing and coding to ensure proper coding and billing accuracy in nursing invoices.
Demonstrates strong problem-solving abilities to investigate and resolve discrepancies, address billing errors, and collaborate with branches and contracted agencies to obtain corrected invoices.

Nice To Haves

Previous relevant experience working in CPR+ and AlayaCare software to audit nursing scheduling, documentation, and billing codes
Related healthcare work experience preferred.

Responsibilities

Audit medical records and obtain required documentation to facilitate invoice creation, timely filing, and accurate monthly revenue. Effectively communicate resolution statuses for billing of nursing services and facilitate billing for other services rendered.
Retrieve or correct necessary documentation from medical record audit and communicate with relevant departments and enter into billing notes.
Collaborate with departments to obtain information for pending revenue resolution for nursing services, medication, and supplies.
Complies with billing audit deadlines.
Identify trends causing delays in pending revenue and work with branch leaders to create action plans.
Analyze metrics related to outstanding days and work with nursing leadership to improve efficiency.
Provide education to the nursing department administrative team to enhance accuracy and compliance.
Perform other duties as assigned by supervisor and Nursing Executive team.