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RN Clinical Auditor

4 weeks ago

New York, United States Hospice of New York Full time
Job DescriptionJob Description

This position will ensure that specific aspects of the clinical documentation are compliant with Federal and State requirements.

You must be a Licensed Registered Nurse to do this role. (RN LICENSE NEEDED)

Before applying please note the Hybrid schedule for this role:

  • Orientation is onsite, in office/field experiences as assigned for 2 full weeks.
  • During probation period (first 90 days), onsite presence in office is mandatory during regular business hours 8:30am-5pm M-F
  • After initial 90 day probationary period, RN Clinical Auditor would be permitted to work a hybrid schedule which meets operational needs, contingent upon performance during 90 day probationary period.
  • Daily work hours 8:30am-5pm with some ability to flex time to work on auditing after hours as preapproved, as long as consistently available for meetings/phone calls during normal business hours

RESPONSIBILITIES:

1. Review identified clinical data contained in patient electronic medical records for completeness, accuracy, and timeliness.

2. Identify deficiencies and communicate findings to Clinical Director/or designee.

3. Track and monitor for clinical compliance with Federal and State requirements.

4. Prepare weekly and monthly reports relative to mandated quality reporting, compliance initiatives, national standards, and relevant organizational educational initiatives.

5. Adhere to agency policies and procedures, identifies departures in policies and procedures related to auditing assignments. Works closely with learning and development on improvement planning.

6. Understands that teamwork is a crucial part of our business, and can work well with colleagues, no matter the circumstances. Using individual skills, cooperates with others, and accepts and provides constructive feedback.

7. Assists in planning and operations of quality assurance, audits, and mock surveys in efforts to provide and improve high quality patient care.

8. Participates in root cause analysis process, adverse event process, and implements findings post review.

9. Assists in furnishing DETAILED EXPLANATION OF NON-COVERAGE (DENC), NOTICE OF MEDICARE NONCOVERAGE (NOMNC), Levanta inquiries, Palmetto, and other third-party requests, information sharing, and appeals.

10. Additional projects as agency requires.

11. Participates in HONY’s quarterly QAPI reporting and presentation.

12. Works directly with QAPI team on new and ongoing improvement projects.

MINIMUM QUALIFICATIONS:

1. Current Professional Registered Nurse license

2. Bachelor's degree

3. Critical thinking ability with attention to details

4. Excellent written and verbal skills

5. Proficiency in EXCEL

6. Navigating EMR system

7. Superior organization skills

8. Must have knowledge of basic medical terminology.

9. Must have three (3) year of experience working in a healthcare environment. Clerical and computer skills required, including data entry.

10. Hospice experience preferred.

 

ADDITIONAL DESIRABLE QUALIFICATIONS

1. Must be proficient in the use of Microsoft programs for internal communications (email) and database tracking/reporting, as well as proficiency working with electronic health records.

2. Committed to the Hospice philosophy.

3. Must have excellent oral and written communication skills and a strong commitment to customer service.

 

The above statements are only meant to be a representative summary of the major duties and responsibilities performed by incumbents of this job. The incumbents may be requested to perform job-related tasks other than those stated in this description.

Company DescriptionHospice of New York is committed to the total care of the patient who is facing a life-limiting illness, care of their family and caregivers, the development of the community's healthcare delivery system, and the conservation of health care resources. We maintain the ethical framework and the standards of excellence in which the staff can fulfill its commitment to deliver the highest quality spiritual, emotional, physical, and psycho-social care of our patients and families.Company DescriptionHospice of New York is committed to the total care of the patient who is facing a life-limiting illness, care of their family and caregivers, the development of the community's healthcare delivery system, and the conservation of health care resources. We maintain the ethical framework and the standards of excellence in which the staff can fulfill its commitment to deliver the highest quality spiritual, emotional, physical, and psycho-social care of our patients and families.

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