What are the responsibilities and job description for the Audit & Medical Review Coordinator position at EMPOWER?
About us:
At Empower, we are proud to serve as a one-stop-shop business partner for healthcare organizations to support their administrative and employer needs. We strive to be more than a workplace, but also a community, where every voice is heard and every team member is valued. Our team is driven by a shared mission to create a positive impact on healthcare organizations and the lives they touch. Join our team today to be part of our mission!
Job Summary:
Responsible for preparing, coordinating, and tracking all correspondence related to external audits and ADR’s. Responsible for the timely submission of ADR’s files and supplemental documentation, insuring they are received/accepted by the auditing organization. Support and equip Medical Review team members as needed.
Essential Functions:
- Coordinates the tracking of all correspondence between external auditors and Empower Services partners.
- Organizes and implements administrative systems and procedures.
- Ability to provide an update regarding the status of Medical Record preparation and ADRs at every level of appeal.
- Gather, Draft, edit and prepare records, correspondence, reports, and other material using word processing, spreadsheets and/or databases.
- Prepares and maintains reports and tracking tools, reviews complex documents, reports etc. keeping them up to date and available to the leadership team.
- Maintains access to e-services and other websites/software such as WayStar, required to obtain record and submit records to auditors.
- May assist in assembling and auditing records.
- May communicate audit results to management
- May assist in creating plans of action to correct deficiencies identified through the audit process.
- Contributes to Empower Services and Compliance department goals by accomplishing related duties as required.
Additional Responsibilities:
- Performs other duties as assigned or requested.
- Conforms to all applicable Agency policies and procedures.
- Participates actively in continuing education and in-services.
- Maintains confidentiality of patient information and business trade practices
- Ability to effectively communicate with clinical and non-clinical employees.
- Ability to perform and prioritize multiple functions or tasks
Knowledge / Skills / Abilities:
- Organizational skills
- Time management
- Cooperative attitude
- Advanced written and verbal interpersonal communication
- Basic math skills related to patient care.
- Self reliant, problem solver.
- Excellent interpersonal, listening and customer service skills.
- Ability to travel if needed.
Minimum Position Qualifications:
- Education:
- Bachelor's degree in a related field
- Experience:
- 1-3 years in audits and medical review, preferred.
- 1-3 years in hospice or home health, preferred.
Environmental Conditions:
Ability to work flexible schedule, ability to travel locally. Moderate noise level; Office Setting
Physical Requirements: Sitting is required. Requires ability to always handle stressful situations in a calm and courteous manner. Requires working under some stressful conditions to meet deadlines and agency needs.
The above statements are intended to describe the general nature and level of work being performed. They are not intended to be construed as an exhaustive list of all responsibilities.
