Chart Auditor

The Chart auditor is a detail oriented professional who assumes the responsibility and accountability for auditing charges for all patient services as well as maintaining compliance at Seton Medical Center and Medical Center Coastside.

Responsibilities

•  Perform concurrent audits: Acute: no less than 10 SNF: no less than 2 reviews
• no less than 2 reviews for both inpatient and outpatient should be one-third of a single days revenue.  Perform insurance/retrospective audits: Represent the hospital in any retrospective audits requested by insurance companies that a concurrent audit has been done by the auditor, in addition to the other retrospective audits.  Retrospective audits.  Collect audit fees when required.  Perform audits requested by the business office: As assigned by the B.O. Director.  Perform special audits: As assign by the CFO or Controller  Analyze audit findings: Assist nursing and ancillary services in identifying areas of weakness resulting in lost revenue and inadequate documentation.
• Assist nursing and ancillary departments in implementing corrective actions to eliminate lost revenue.
• Provide continuous feedback to all revenue departments regarding audit findings.  Prepare the preliminary monthly audit report: Include the monthly findings for both concurrent and retrospective audits, i.e., monthly totals over and under charges.
• Identify all problem areas, and the proposed solutions.
•  Employee has the willingness and ability to perform additional duties and responsibilities in differentareas of the department on an as-needed basis or as determined by management.  Follows established hospital and department policies. No more than 2 written substantiated complaints representing a breach of policy, procedure or professional behavior since last evaluation.  Demonstrates the philosophy of team concept.  Participates in group projects and staff meetings with suggestions that enhance the work environment and increase productivity.  Communicates well with supervisor reporting problems with equipment, supplies, or procedures.
• Requests assistance as appropriate.  Maintains patient confidentiality  Exhibits willingness to resolve problems as they arise.  Consistently projects positive professional image through appearance and behavior.  Attends 75% of staff meetings or reads and initials minutes.  Completes assigned work within shift.
• Guest/Interdepartmental Relations  As observed by representatives of management, all interactions are conducted in a professional manner.  Verbal and written feedback from patients, family members/significant others, medical staff, visitors and co- workers indicates behavior conducive to positive guest relations.  Consistently exhibits appropriate phone protocol (e.g., answers phones promptly, is courteous and helpful).  Consistently contribute to the team effort (e.g., assists co-workers when need is observed or upon request, offers constructive suggestions rather than complaints).  Consistently displays cheerful and positive attitude.
•  Completes annual safety updates within established time frames.  Completes general and departmental orientation within established time frames.  Attends 80% of in-service programs.  Maintains licensure/certification as appropriate
• Improvement  Consistently strives to understand, anticipate and meet the needs, expectations and satisfaction levels of patients and other "customers".  Errors, inefficiencies and inaccuracies are brought to management's attention with suggestions for improvement.  Develops innovative solutions to departmental problems.
• 1dentifies and implements methods of controlling costs or generating revenue while providing maximum value to both the patient/customer and the hospital.  Maximizes efficiency in all departmental operations.
• Measures progress against quality goals.

Requirements

• EDUCATION: High school diploma or equivalent, Bachelor’s degree preferred EXPERIENCE:  Minimum of two years of healthcare experience CPT understanding Billing experience preferred CCS preferred OTHER SKILLS, ABILITIES & KNOWLEDGE:  Strong computer skills, including
• Microsoft programs Strong analytical skills Strong communication skills, written and oral  Solid problem solving abilities Ability to work independently with moderate supervision Demonstrates the ability to follow instructions well  Generates quality work product in a timely manner  Knowledge of CMS Regulations regarding patient charging

Department Specific Competencies  Cultural Competency

Exhibits Culturally Responsive Attitude Including Flexibility, Empathy, Respect and Awareness of Communication Needs.