RN Auditor

Company: Valley Medical
Location: Burnsville
Posted on: May 16, 2022

Job Description:

Job DescriptionSalary: Job Overview: Utilize clinical expertise and knowledge to perform comprehensive audits on electronic medical record charts to ensure accuracy and completeness of the data elements abstracted such as Diagnosis, Medications, Allergies, Histories, Results and other data as defined by the Regulatory and Compliance Manager.Primary Responsibility:

• Perform internal quality audits on medical charts to ensure accuracy and completeness of the medical record on a daily and monthly basis
  • If an appeal arises, be able to support findings
  • Validate both the coding accuracy and appropriateness of services given to patients
    • Demonstrates ability to appropriately apply clinical criteria to a variety of claims scenarios and effectively utilize audit tools.
      • Perform Daily and Monthly Medical Record Audits
      • Formulate data driven metrics in excel
        • Audit and organize medical records for audits
        • Maintains detailed audit tracking in alignment with the Quality Audit standards
        • Generate reports /findings of reviews for the Clinical Management Teams: in a clear, concise manner that is understandable. Identify trends in quality reports and collaborate with management and stakeholders to ensure solutions are implemented
        • Assist in development of Quality policies, processes and standards
        • Consults with Lead APP to calibrate on subjective assessments to ensure consistency of feedback related to complex, high risk cases
        • Participates, supports, and assists with project-specific initiatives
        • Maintains current knowledge of clinical guidelines
        • Other duties as assigned Preferred Skills and Knowledge:
          • Familiarity with clinic settings, basic standards of medical care, and medical terminology
          • Strong communication, presentation, facilitation, and interpersonal skills
          • Proficient in the use of Microsoft Office Products including Excel, Word, and PowerPoint
            • EMR Experience
            • Excellent critical thinking skills
            • Able to work in fast-paced environment and meet productivity goals
            • Able to perform work with a high degree of accuracy and attention to detail.Required Education, Experience, and Credentials:
              • Active and unrestricted RN License
              • 3+ years of clinical nursing experience in the inpatient setting
              • Excellent analytical skills, including the ability to evaluate a broad scope of data to define potential risks
              • 1+ years of experience in advanced clinical documentation review or audit experience
              • Excellent communication skills, both written and verbal. Proven ability to communicate with employees at all levels of the firmAdditional Position Details: (hours, locations, commute)
                • Constantly required to sit, use hands to handle or feel, talk and hear
                • Constantly required to use a computer monitor screen for most of working-day
                • Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus between computer monitor and working space
                  • Day Shift Monday-Friday
                    • This position is eligible for hybrid work from home model. 3 days a week on site, 2 days a week work from home.
                    • Work is predominantly based in Burnsville MN location with occasional travel to other VMW clinic sites.Benefits Include:
                      • Competitive Salary
                      • Medical, Dental and Vision
                      • Cell phone reimbursement
                      • 401K
                      • Discretionary Profit Sharing
                      • Life Insurance/Disability
                      • Paid Time Off
                      • Paid Holidays
                      • and MOREFLSA Status: Exempt

Keywords: Valley Medical, Burnsville , RN Auditor, Healthcare , Burnsville, Minnesota