Nurse Auditor Days OR exp is required
Nurse Auditor Days OR exp is required
Employer Active
Job Alert
You will be updated with latest job alerts via email
Share
Job Alert
You will be updated with latest job alerts via email
Not Disclosed
Salary Not Disclosed
1 Vacancy
Job Description
Overview
Houston Methodist Standard
PATIENT AGE GROUP(S) AND POPULATION(S) SERVED
Refer to departmental Scope of Service and Provision of Care plans as applicable for description of primary age groups and populations served by this job for the respective HM entity.
HOUSTON METHODIST EXPERIENCE EXPECTATIONS
- Provide personalized care and service by consistently demonstrating our I CARE values:
- INTEGRITY: We are honest and ethical in all we say and do.
- COMPASSION: We embrace the whole person including emotional ethical physical and spiritual needs.
- ACCOUNTABILITY: We hold ourselves accountable for all our actions.
- RESPECT: We treat every individual as a person of worth dignity and value.
- EXCELLENCE: We strive to be the best at what we do and a model for others to emulate.
- Practices the Caring and Serving Model
- Delivers personalized service using HM Service Standards
- Provides for exceptional patient/customer experiences by following our Standards of Practice of always using Positive Language (AIDET Managing Up Key Words)
- Intentionally collaborates with other healthcare professionals involved in patients/customers or employees experiential journeys to ensure strong communication ease of access to information and a seamless experience.
- Involves patients (customers) in shift/handoff reports by enabling their participation in their plan of care as applicable to the given job
- Actively supports the organizations vision fulfills the mission and abides by the I CARE values
Responsibilities
- Collaborates and works fluidly with the Business/Finance office(s) to communicate audit results. Delivers a list of exceptions needing corrective action based on audit results to management.
- Opens and reviews case records for consistency and accuracy in documentation. Trains and educates staff on documentation and charging process.
- Collaborates as appropriate with outside auditors who audit specific patients accounts for items not documented and to determine what is and is not allowable.
- Provides contributions to improve department scores for turnover/retention.
SERVICE ESSENTIAL FUNCTIONS
- Assists with intradepartmental data collection associated with various external internal and administrative audits.
- Prepares and presents monthly audit reports complete with findings of discrepancies or exceptions.
QUALITY/SAFETY ESSENTIAL FUNCTIONS
- Audits and reconciles patient charts services and items included in the patients chart with services and items included on the patients bill on a daily basis or upon request from Payors onsite auditors Patient Accounting Risk Management Revenue Cycle and other network hospital entities needing completion of audit for reasons of treatment payment or operations. Performs quality and safety audits through review of patient and other records through direct observations as appropriate. Exercises sound clinical judgment discretion and initiative when performing data audits.
- Intervenes and takes appropriate action to foster realtime compliance to performance measures associated with regulatory national and regional guidelines. Interventions to promote compliance may include discussion and/or collaboration with physicians nurses other healthcare personnel and patients.
- Utilizes results from performance improvement activities to identify and prioritize areas of focus for improvement. Evaluates and provides input on the effectiveness of performance improvement programs. Role models situational awareness using teachable moments to improve safety.
FINANCE ESSENTIAL FUNCTIONS
- Organizes and reconciles daily workdrivers to ensure accountability of all audits assigned and to ensure audits are worked in proper priority. Recognizes that customer service and fiduciary responsibility must be balanced.
- Effectively models independent time management and prioritization of daily tasks.
GROWTH/INNOVATION ESSENTIAL FUNCTIONS
- Fosters identification and implementation of innovative solutions to improve department operations by leading and/or participating in hospital projects and shared governance activities where appropriate.
- Identifies and assumes responsibility of own learning needs seeks continuing education opportunities to meet those needs. Completes and updates the My Development plan on an ongoing basis. Ensures own career discussions occur with appropriate management.
This job description is not intended to be allinclusive; the employee will also perform other reasonably related business/job duties as assigned. Houston Methodist reserves the right to revise job duties and responsibilities as the need arises.
Qualifications
- Graduate of education program approved by the credentialing body for the required credential(s) indicated below in the Certifications Licenses and Registrations section.
WORK EXPERIENCE
- Three years of hospital clinical experience preferably in a surgical setting
- One year of experience auditing in a surgical or hospital setting
License/Certification
- RN Registered Nurse Texas State Licensure and/or Compact State Licensure within 60 days OR
- RNTemp Registered Nurse Temporary State Licensure within 60 days
KSA/ Supplemental Data
- Demonstrates the skills and competencies necessary to safely perform the assigned job determined through ongoing skills competency assessments and performance evaluations
- Sufficient proficiency in speaking reading and writing the English language necessary to perform the essential functions of this job especially with regard to activities impacting patient or employee safety or security
- Ability to effectively communicate with patients physicians family members and coworkers in a manner consistent with a customer service focus and application of positive language principles
- Ability to learn and apply use of databases for aggregation of data for analysis
- Ability to independently analyze and solve problems
- Computer proficiency to complete job duties independently
- Expertise in medical staff quality initiatives
- Strong research interpretation skills
- Time management and prioritization skills
- Flexibility and ability to adapt to change
SUPPLEMENTAL REQUIREMENTS
WORK ATTIRE
- Uniform No
- Scrubs Yes
- Business professional Yes
- Other (department approved) Yes
ONCALL*
*Note that employees may be required to be oncall during emergencies (ie. DIsaster Severe Weather Events etc) regardless of selection below.
- On Call* No
TRAVEL**
**Travel specifications may vary by department**
- May require travel within the Houston Metropolitan area Yes
- May require travel outside Houston Metropolitan area Yes
Company Profile
Houston Methodist West Hospital is committed to leading medicine in West Houston Katy and surrounding communities by delivering the Houston Methodist standard of exceptional safety quality personalized service and innovation. The growing campus offers more than 200 beds 19 operating rooms and over 1500 employees with access to the most innovative medical and surgical care available including robotic and minimally invasive surgery fullspectrum heart care stateoftheart imaging cancer care labor and delivery with a level II neonatal ICU neurology and neurosurgery orthopedics and sports medicine outpatient rehabilitation and 24/7 emergency services.
Employment Type
Full-Time
