Quality Assurance Nurse

2 weeks ago

Harlingen, United States Sunglo Home Health Service Inc. Full time
*Job Summary*

QUALITY ASSURANCE

* Works with Billing Department/Office Manager on the undropped list to ensure that documentation supports claim for payment.
* Gives appropriate feedback to staff on individual basis at least weekly in an effort to maintain standards on documentation.
* Informs Supervisor and nursing supervisory staff on a regular basis of problem areas in terms of documentation.
* Participates in weekly case conferences and shares Recert audit findings with staff
* Audits charts for Medicare denials and ADR’s prior to submitting chart to Supervisor.
* Reviews charts for quality of care rendered; i.e. orders followed, appropriate utilization of visits, appropriate contacts with physician and other disciplines. Will be rated by supervisor based on findings.
* Reviews SOC’s, Recerts, ROC’s as soon as received from Coders. Distributes packets to appropriate RN for signatures and corrections.
* Reviews packets received from RN to confirm signatures, dates and corrections were completed and removes all stickies’ before sending to Medical Records.
* Reviews all discharged charts for completeness before Discharge summary is sent to MD within 48 hours of discharge.
* Obtains the Monthly Recert List from Data, to schedule chart audits
* Schedules chart audits 2 weeks before RN will do Recert, using Recert Audit Form
* Completes the Recert Audit form by auditing the entire chart and places form in the RN Recert packet.
* Audits daily notes for proper documentation and timely notification to field staff
* Audits Med updates for completion; telephone orders for contents and frequency verification.
* For all visit increases, an *Additional Visit Request Form* will be completed and faxed to Administrator for approval before visits are done. Audits for abbreviations on the “Do not Use Abbreviations” list.
* Audits therapy notes for specific orders for treatment “NOT” “modalities as needed”
* Follows up with new employees on proper documentation and timely submittal of paperwork and informs Orientation Department of further training required.
* Follows up on corrections by using the Deficiency forms after signed and submitted by staff
* Submits a Daily QA report to Supervisor for DOPS/Administrator production review.

OTHER DUTIES

* Continually strives to improve knowledge within their field.
* Functions as a staff nurse at the direction of the Director of Professional Services when the need arises.
* Collects and files in specified Binders all Hospitalizations, Infections, Incidents and falls
* Maintains Lab log for all lab documentation especially PT/INR, and Dilantin Level and MD follow-up.

Job Type: Full-time

Pay: $15.00 - $22.00 per hour

Standard shift:
* Day shift
Supplemental schedule:
* On call
Weekly schedule:
* Monday to Friday
* Rotating weekends

Ability to Relocate:
* Harlingen, TX 78550: Relocate before starting work (Required)

Work Location: In person

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