The Medical Record Reviewer executes audits as a part of the Company's clinical compliance audit and Quality Assurance controls program. The Medical Record Reviewer executes clinically-related (i.e. medical record and related treatments) audit procedures to assess compliance-related controls to safeguard company resources and ensures the effectiveness and efficiency of clinical treatment and document compliance. The Medical Record Reviewer, in conjunction with Director of Quality/Risk Management, the Medical Staff, the Director of Nursing, and the Director of Therapy makes recommendations for improvement of controls in processes to ensure risk management, control and regulatory standards are being followed as intended, and will enable the objectives and goals to be met.
License or Certification:
- RN licensure in the state where employed preferred
Education, Training and Years of Experience:
- Minimum of four years health care experience in clinical documentation and related regulatory requirements required. Experience with inpatient and/or outpatient rehab preferred, but not required.
- Associates or bachelors degree in nursing preferred.
- Knowledge of health care regulations and with coding guidelines for ICD-10-CN, CPT-4, PPS, and governmental reimbursement laws and regulations.
- Working knowledge of auditing techniques and auditing standards.
- PC literate (Microsoft Word, Excel, and email).
Machines, Equipment Used:
- General office equipment such as telephone, copy machine, fax machine, calculator, computer.
- Good visual acuity and ability to communicate.
- Ability to lift a minimum of 10 pounds and ability push/pull a minimum of 10 pounds, which includes the lifting, pushing and/or pulling of medical supplies, documents, and equipment. Reasonable assistance may be requested when lifting, pushing, and/or pulling are undertaken which exceeds these minimum requirements.
- Ability to withstand prolonged standing and walking.
- Ability to reach, stoop, bend, kneel, and crouch are required for patient care functions and in setting up and monitoring equipment
Skills and Abilities:
- Ability to speak, read, write, and communicate effectively.
- Ability to coordinate, analyze, observe, make decisions, and meet deadlines in a detail-oriented manner.
- Ability to work independently without supervision.
- Indoor, temperature controlled, smoke-free environment. Occasional outdoor exposure.
- Exposure or potential exposure to blood and body fluids may be required.
- Handicapped accessible.
- May work under stressful circumstances at times.
Proficiency or Productivity Standards:
- Meets established attendance standards.
- Adheres to hospital/department dress code including wearing ID badge.
- May be required to work weekdays and/or weekends, evenings and or night shifts if needed to meet deadlines.
- May be required to work on religious and/or legal holidays on scheduled days/shifts.
- Will be required to work as necessary during disaster situations, i.e., before, during or after a disaster.
- May be required to stay after workday to assist after a disaster situation until relief arrives.
- May be required to perform other duties as assigned by supervisor
Address: 4700 W 69th Street, Sioux Falls 57108
Shift: Day Job
Job ID: 2230198