Corporate Auditor QA

3 days ago

Lexington, United States Medical Services of America Full time
Job DescriptionJob Description

MSA Home Health & Hospice is currently seeking experienced Full-Time Corporate Auditor QA for our location in Lexington, SC. Two applicants desired.

  • Conducts Home Health & Hospice agency reviews to assess clinical outcomes, operational processes, compliance, state survey results, etc. as requested
  • Conducts clinical record reviews and presents results to corporate and agency leadership
  • Conducts clinical record reviews for audits such as ADRS, RACs, ZIPCs, etc. Provides feedback to agencies on need items and ensures, with the help of the local administrator, that the records are submitted in the timeframe of the request
  • Conduct clinical record reviews for appeals. Provides feedback to the agencies on needed items and ensures, with the help of the local administrator, that the records are submitted in the timeframe of the request
  • Assist agencies in times of need with auditing and review of active and discharged location charts
  • Keeps abreast of Medicare guidelines and the latest updates
  • Assists in developing and implementing Corporate Action Plans related to Medicare changes. Educates staff.
  • Assist agency as corporate clinical manger as needed. Following tasks apply
  • Responsible for initial and on-going clinical coordination of care with all disciplines and coding team members
  • Receives, resolves and completes notifications received for various processes in the EMR system
  • Ensures compliance with MSA processes
  • Consults with clinician and coding team members as needed for questions or changes regarding patient assessments
  • Reviews assessments and Oasis documentation prior to physician order generation
  • Reviews all initial and recertification physician orders for appropriateness and completeness in comparison to Oasis. Discusses any issues or corrections with clinician
  • Audits physician’s modified orders for accuracy, legibility and content prior to forwarding to physician’s office for signature
  • Conducts a pre-discharge clinical audit to include the review of patient goals and plan of care with the clinician prior to any discharge discussions with the patient
  • Verifies that all goals were met and interventions are completed. If goals were not met or intervention was not completed, ensures there is supporting documentation
  • Audits patient EMR for completeness and confirms that the Transfer and Discharge summaries are sent to the patient’s receiving facility and all of patient’s physicians
  • Responsible for ensuring the referral date and SOC date are accurately documented within the EMR
  • Review of oasis submission file rejections (fatal errors, warnings, etc.) and performs required changes to correct fatal errors
  • May assist with agency QAPI. Audits Adverse events review; falls / infections; medication evaluation review
  • Review pre-billing type reports, at regular intervals, for issues that impact billing release. Assures staff accuracy, accountability and timeliness for all required documentation
  • Participates in the agency’s quality improvement program
  • Works collaboratively with the corporate clinical manager and corporate staff development to accomplish additional directives
  • Contributes to team effort to accomplish related results as needed

Qualifications and Skills

  • Bachelor’s degree in nursing
  • Currently licensed as an RN
  • Ability to procure multiple state RN licensures as required
  • Minimum of five years home health and/or hospice administration experience
  • Six months to one year recent training and/or teaching experience
  • Broad knowledge of home health and/or hospice agency regulations
  • Excellent organization, problem solving, decision making, presentation and written communication skills
  • Ability to travel frequently with minimal advance notice
  • Proficiency with Microsoft Office (Word, Excel, PowerPoint, Outlook, etc.)
  • . Previous leadership experience

MSA offers competitive pay and excellent benefits:

  • Generous paid time off
  • Medical/Prescription, Dental & Vision Insurance and other benefits (STD, LTD, Accident & Sickness, additional life insurance, etc.)
  • Company paid employee life insurance
  • 401(k) retirement with a generous company match
  • Opportunities for advancement
  • Many other great benefits

We are an Equal Opportunity Employer

To learn more, visit us online at www.MSAhealthcare.com

Job Type: Full-time

 

Company DescriptionMedical Services of America began with a unique concept, "total home health care," and its expansion has been guided with that concept in mind. MSA is now a comprehensive home healthcare provider that offers home healthcare, hospice care, home medical equipment and supplies, diabetic supplies, respiratory services, mail order supplies, enteral nutrition therapy, senior/assisted living and physician practice management.Company DescriptionMedical Services of America began with a unique concept, "total home health care," and its expansion has been guided with that concept in mind. MSA is now a comprehensive home healthcare provider that offers home healthcare, hospice care, home medical equipment and supplies, diabetic supplies, respiratory services, mail order supplies, enteral nutrition therapy, senior/assisted living and physician practice management.

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