Tabitha

Quality Assurance RN Auditor

US-NE-Lincoln
1 week ago
ID
2017-5121
Type
Regular Full-Time
Work Hours
8-5
Weekend Rotation
n/a
Hours Per Week
40
Shift
Day

Overview

Tabitha offers Nebraska’s first and only comprehensive line of Elder Care services. Through advanced in-home support, innovative living communities, exceptional rehabilitation services, experienced skilled nursing care and compassionate hospice support, Tabitha is your answer for Elder Care in southeast Nebraska.

Responsibilities

JOB SUMMARY:

  • The nurse auditor is responsible for assuring home health clinical records:
  • Meet state/federal regulations and third party payer requirements;  
  • Comply with OASIS guidelines
  • Reflect an accurate clinical picture of the HHC client
  • Demonstrate congruency between clinical record documentation and the clinical and financial outcomes  

 

ESSENTIAL FUNCTIONS:

1. Performs clinical record audits to assure that content and documentation meet regulatory requirements for licensure, billing, and follow OASIS guidelines.

2. Reviews clinical record for quality and congruency of documentation to maximize reimbursement and accuracy of outcomes.

3. Performs timely follow up to ensure that all corrections have been completed.

4. Compiles and reports audit findings to Quality Assurance Coordinator, for reporting to administrator, Clinical Excellence Committee and the Board.

5. Serves as a resource and provides education to clinical staff on accurate documentation, standard documentation protocols and OASIS guidance.

6. Collaborates with the accounting department to insure billing compliance and timely submission of data and invoices.

7. Identifies trends and patterns in individual performance, as well as team trends and gaps, and may participate in problem solving and coaching of individuals.   

8. Works independently towards individual metrics, and interdependently to ensure audit team reaches goals and meets deadlines.  

9. Demonstrates competency and articulates to field staff and new employees HHC regulations and OASIS guidelines.

10. Investigates potentially avoidable events and collates results to identify gaps in the agency practice.

11. Participates in the management of the telehealth clients through coordination of care with clinical team, reviewing data daily and charts to assure standard of care is met.

12. Demonstrates strong clinical assessment skills and current evidence based practice for nursing.

13. Demonstrates strong technical skills with software used by the agency for outcome management and clinical record documentation.

14. Demonstrates leadership qualities of collaboration, communication and customer service.

15. Participates in orientation of new staff.

16. Safeguards confidentiality of client information

17. Follows established policies and procedures in performing all duties

18. Actively participates in performance improvement / quality assurance activities and work teams that foster improved clinical outcomes for the agency.

19. Attends mandatory in-services and staff meetings.

 

 

Qualifications

LICENSURE / CERTIFICATION

Current Nebraska licensure as Registered Nurse

Current driver's license and car insurance

 

EDUCATION AND EXPERIENCE

Graduate of accredited school of nursing required

OASIS experience preferred

Experience in Long Term Care, Hospice, or Home Health Care preferred

Audit experience preferred

 

KNOWLEDGE, SKILLS AND ABILITIES

Must have a good command of the English language and the ability to communicate effectively, both orally and in writing

Must be able to work independently

Must understand the requirements for clinical record content

Must know and understand the Medicare / Medicaid conditions of participation

Must be computer literate and able to utilize various software packages

 

WORKING CONDITIONS: 

Works indoors in well lighted surroundings

Sits for long periods of time when auditing records

Ability to lift 25 pounds

 

EQUIPMENT OPERATION:

Frequent use of computer and telephone

Occasional use of Fax machine and Copy machine.

 

STATEMENT OF EQUAL EMPLOYMENT OPPORTUNITY AND AFFIRMATIVE ACTION

Tabitha Health Care Services is an equal employment opportunity employer and does not discriminate in employment on the basis of race, religion, color, national origin, citizenship, creed, gender, sexual orientation, age, veteran status, mental or physical disability, genetic information, or any other characteristic protected by federal, state, or local law.  This policy applies to all employment practices and decisions including recruitment, selection, hiring, training, transfer, promotion, compensation, benefits, and the termination of employment. 

 Furthermore, Tabitha Health Care Services will make reasonable accommodations for qualified individuals with known disabilities unless doing so would result in an undue hardship, safety, and/or health risk.  Please contact Tabitha Health Care Services Human Resources Department to request an accommodation.

 As a government contractor, the organization has adopted written Affirmative Action Plans for women and minorities, protected veterans and individuals with disabilities. These plans will be revised on an annual basis. Tabitha Health Care Services is committed to making a good-faith effort toward achieving the objectives of the Plans. Any employee who would like to review the Plans may do so by scheduling an appointment with the Human Resources Department during normal business hours.

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