What are the responsibilities and job description for the Clinical Auditor-Horizons- Full Time position at Hutchinson Regional Healthcare System?
Reviews and monitors medical record documentation for quality, appropriateness of care and services billed within mental health services. The position works in concert with Medical Records, Clinical Services, Medical Services and Rehab Services to assure that documentation meets the requirements of all payer sources, contracts, licensure and accreditation standards.
Actively participates in outstanding customer service and accepts responsibility in maintaining relationships that are equally respectful to all.
Actively participates in outstanding customer service and accepts responsibility in maintaining relationships that are equally respectful to all.
ESSENTIAL FUNCTIONS:
- Audit documentation for Behavioral Health Services.
- Implement auditing according to agency procedures, licensing, payor source and accreditation standards to monitor for clarity of documentation, quality and appropriateness of care, medical necessity and justification of billing.
- Provide written feedback to staff and help track and trend areas needing improvement as well as those in which staff are proficient. Monitor compliance with required medical record documentation by clinical staff and provide feedback in the monthly UR meeting.
- Design and implement training for Horizons employees as needed.
- Maintain knowledge of documentation requirements for licensing, accreditation and for all payer sources.
- Other duties as assigned.
MINIMUM KNOWLEDGE AND SKILLS REQUIRED:
- Excellent typing and spelling skills.
- Proficient in MS Word and Excel.
- General familiarity with office equipment operations.
- Good organizational skills, follow thru and attention to detail.
- Ability to communicate concepts and lead the change process while maintaining respect for others.
PREFERRED KNOWLEDGE AND SKILLS REQUIRED:
- N/A
REQUIRED BEHAVIORAL SKILLS:
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Integrity:
- A personal presence which is characterized by a sense of honesty and the willingness to do the right thing.
- The ability to role model, inspire and motivate others to promote the philosophy, mission, vision, goals and values of Hutchinson Regional Healthcare System.
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Compassion:
- A personal presence which is characterized by a sense of caring that is reflected in a high level of empathy and customer service with all that we come in contact.
- Ability to manage conflict, consider other points of view, and offer alternative solutions without jeopardizing overall project direction and the ability to manage customer expectations.
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Accountability:
- Demonstrated track record of ownership of situations, projects and issues.
- Able to work autonomously and have a high degree of flexibility to adapt to changing projects, priorities and work volumes.
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Respect:
- Demonstrated ability to collaborate with a diverse population.
- Treat all internal and external customers with a positive, proactive service orientation.
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Excellence:
- Strong communication and presentation skills with a proven ability to influence and lead teams to conclusion/decision making.
- Proven ability to think strategically but also must be able to lead day-to-day tactical processes.
- Demonstrated ability to manage and provide coaching and leadership on complex projects.
- Must be able to lead and/or facilitate process improvement.
MINIMUM EDUCATION AND EXPERIENCE REQUIRED:
- Bachelor’s degree in psychology or social work.
PREFERRED EDUCATION AND EXPERIENCE:
- N/A
REQUIRED LICENSE/REGISTRATION/CERTIFICATION:
- N/A
PREFERRED LICENSE/REGISTRATION/CERTIFICATION:
- N/A
We offer competitive pay, a generous benefit package and a reason to be proud of what you do, every day.
