Surgical Services Auditor

4 weeks ago

Washington, Washington, D.C., United States MEDSTAR HEALTH Full time

General Summary of Position
Serves as the auditor for all Perioperative Services, ensuring timely and accurate information. Supports regulatory compliance as well as the revenue cycle to ensure each case record is accurate and all supply items have been assigned the appropriate charge. Under the direction of the Business Director for Perioperative Services, the Surgical Service Auditor will be responsible for reviewing clinical documentation within all Perioperative and Procedural departments to audit for charging accuracy, regulatory compliance, and quality outcomes. The Surgical Service Auditor will partner with service line managers, clinic/procedural schedulers, Supply Chain associates and the Perioperative Charge Entry Coordinator.

Primary Duties and Responsibilities

Reviews clinical documentation to determine if charging for the procedure, supplies, implants, recovery, and any other associated charges are documented accurately.Reviews monthly spend while identifying opportunities to reduce expense.Participates in the process of assigning and reviewing HCPC and charge codes assigned to implants and supplies.Reviews OR records for use of supplies not appearing on the billing document. Initiates the build process for items that are not built into the EMR.Participates in feedback process with nurse managers, and clinicians to ensure documentation is corrected in a timely manner.Ability to work in multiple software applications to collaborate with supply chain and billing compliance to audit and identify the correct pricing and charging of supplies and implants.Works with vendors to obtain pricing/product information to maintain an accurate item master. Assigns a charge description master (CDM) number to non-stock specialty items and implants.Reviews and initiates purchase orders for the payment of supplies and equipment. Keeps records of purchases and audits/tracks patient and interdepartmental charges.Oversees the implementation and accuracy of new Perioperative contracts to ensure accurate pricing is maintained in the EMR. Reviews vendor invoices for specialty items and implants for corresponding OR cases to ensure accuracy of patient charges for billing documents.Assesses appropriate clinical documentation.Participates as ad-hoc Value Analysis committee members. Supporting VAC leadership in product/equipment assessment.Oversees the `un-finalized' case reports in Perioperative services and works with clinical staff to complete all documentation both timely and accurately.Knowledgeable of Hospital policies and organizational identi¿ed quality initiatives; incorporates this knowledge into audits to help drive documentation compliance in partnership with unit leadership.Partners with service line clinic and procedural schedulers, OR managers, resource nurse or supply coordinator, and revenue control specialists to develop a working relationship and effective work group for problem solving.Develops and maintain clinical knowledge of areas auditing, to maintain a clear understanding of what should be found within documentation.Provides OR information system training for clinical and non-clinical staff.Provides OR system administration and hardware troubleshooting support as needed

Minimum Qualifications
Education

  • Associate's degree required
  • Bachelor's degree of Nursing preferred

Experience

  • 1-2 years of progressively more responsible experience as a Surgical Technologist or as an RN with surgical nursing experience required

Licenses and Certifications

  • CST - Certified Surgical Technologist preferred or
  • RN - Registered Nurse - State Licensure and/or Compact State Licensure preferred

Knowledge, Skills, and Abilities

  • Familiarity with OR information systems, supply chain management information systems, procedures and supplies used in surgery as well as surgical subspecialties,
  • Knowledge of Medical terminology, knowledge of procedural or surgical clinical workflows and documentation requirements.

Why MedStar Health?
At MedStar Health, we understand that our ability to treat others well begins with how we treat each other. We work hard to foster an inclusive and positive environment where our associates feel valued, connected, and empowered. We live up to this promise through:

  • Strong emphasis on teamwork - our associates feel connected to each other and our mission as an organization. In return, our effective team environment generates positive patient outcomes and high associate satisfaction ratings that exceed the national benchmark.
  • Strategic focus on equity, inclusion, & diversity - we are committed to equity for all people and communities. We continue to build a diverse and inclusive workplace where people feel a sense of belonging and the ability to contribute to equitable care delivery and improved community health outcomes at all levels of the organization.
  • Comprehensive total rewards package - including competitive pay, generous paid time off, great health and wellness benefits, retirement savings, education assistance, and so much more.
  • More career opportunities closer to home - as the largest healthcare provider in the Baltimore-Washington, D.C. region, there are countless opportunities to grow your career and fulfill your aspirations.

About MedStar Health
MedStar Health is dedicated to providing the highest quality care for people in Maryland and the Washington, D.C., region, while advancing the practice of medicine through education, innovation, and research. Our team of 32,000 includes physicians, nurses, residents, fellows, and many other clinical and non-clinical associates working in a variety of settings across our health system, including 10 hospitals and more than 300 community-based locations, the largest home health provider in the region, and highly respected institutes dedicated to research and innovation. As the medical education and clinical partner of Georgetown University for more than 20 years, MedStar Health is dedicated not only to teaching the next generation of doctors, but also to the continuing education, professional development, and personal fulfillment of our whole team. Together, we use the best of our minds and the best of our hearts to serve our patients, those who care for them, and our communities. It's how we treat people.

MedStar Health is an Equal Opportunity (EO) Employer and assures equal opportunity for all applicants and employees. We hire people to work in different locations, and we comply with the federal, state and local laws governing each of those locations. MedStar Health makes all decisions regarding employment, including for example, hiring, transfer, promotion, compensation, benefit eligibility, discipline, and discharge without regard to any protected status, including race, color, creed, religion, national origin, citizenship status, sex, age, disability, veteran status, marital status, sexual orientation, gender identity or expression, political affiliations, or any other characteristic protected by federal, state or local EO laws. If you receive an offer of employment, it is MedStar Health's policy to hire its employees on an at-will basis, which means you or MedStar Health may terminate this relationship at any time, for any reason.

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