CHART AUDITOR

JPS Health Network; Fort Worth (TX); On-site; USD 52,000 - 78,000; Full time

Job summary

The Chart Auditor will perform clinical reviews to determine the accuracy of ICD-10 codes on forms from payors, conduct outreach for the Transition of Care program, validate ED high utilization attribution, and review gap in care reports to address patient health risks. This role requires accessing proprietary systems to audit medical records and document findings for clinic providers.

Requirements include LVN/RN licensure and 2+ years of clinical experience; Bachelor’s in Nursing is preferred.

Qualifications

• Relevant clinical experience in chart reviews or payor reviews.
• Experience auditing medical records and ICD-10 coding guidance.

Responsibilities

• Review medical records and forms to verify ICD-10 coding accuracy.
• Document decisions and rationale for review findings.
• Pend orders to address outstanding patient care gaps.
• Perform outreach for patients discharged from inpatient stays.
• Assist management with training new Chart Auditor.
• Maintain knowledge of clinical criteria to uphold licensure.
• Attend trainings and meetings to improve clinical policies and procedures.
• Cross-train to review multiple payor types and requirements.
• Suggest and test process improvements and audit concepts.
• Review payor gap in care reports to validate medication adherence.

Skills

Clinical experience

Medical records auditing

Education

RN or LVN licensure

Job description

Who We Are
JPS Health Network is a $950 million, tax-supported healthcare system in North Texas. Licensed for 582 beds, the network features over 25 locations across Tarrant County, with John Peter Smith Hospital a Level I Trauma Center, Tarrant County's only psychiatric emergency center, and the largest hospital-based family medical residency program in the nation. The health network employs more than 7,200 people.

Acclaim Multispecialty Group is the medical practice group featuring over 300 providers serving JPS Health Network. Specialties range from primary care to general surgery and trauma. The Acclaim Multispecialty Group formed around a common set of incentives and expectations supporting the operational, financial, and clinical performance
outcomes of the network. Our goal is to provide high quality, compassionate clinical care for every patient, every time.

Why JPS?

We're more than a hospital. We're 7,200 of the most dedicated people you could ever meet. Our goal is to make sure the people of our community get the care they need and deserve. As community stewards, we abide by three Rules of the Road:

1. Own it.Everyone who wears the JPS badge contributes to our journey to excellence.
2. Seek joy.Every day, every shift, we celebrate our patients, smile, and emphasize positivity.
3. Don't be a jerk.Everyone is treated with courtesy and respect. Smiling, laughter, compassion - key components of our everyday experience at JPS.

When working here, you're surrounded by passion, diversity, and dedication. We look forward to meeting you!

Job Summary:

The Chart Auditor will be responsible for performing clinical reviews to determine the accuracy of ICD-10 codes listed on forms from payors, performing interactive outreach for the Transition of Care program, pending outstanding patient orders, validating ED high utilization patient attribution, and reviewing gap in care reports to address outstanding patient health risks. This job involves accessing proprietary systems to audit medical records, accurately documenting findings, and providing forms to the clinic providers.

Essential Job Functions & Accountabilities:

• Reviews and interprets medical records and compares against forms for accuracy of presumed diagnoses.
• Documents decisions and rationale to justify review findings.
• Pend orders to address outstanding patient care gaps.
• Performs interactive outreach for patients discharged from Inpatient stays.
• Assists management with training any new Chart Auditor.
• Maintains current knowledge of clinical criteria guidelines to maintain a clinical license.
• Responsible for attending training and scheduled meetings to enhance skills and working knowledge of clinical policies, procedures, rules, and regulations.
• Actively cross-trains to perform reviews of multiple payor types and requirements and understand the documentation needs.
• Recommends, tests, and implements process improvements, new audit concepts, and technology improvements that will enhance production, quality, and client satisfaction.
• Reviews payor gap in care reports to validate patient medication adherence compliance.
• Validates and facilitates care management for high ED utilizing patients.
• Job description is not an all-inclusive list of duties and may be subject to change with or without notice. Staff are expected to perform other duties as assigned.

Qualifications:

Required Qualifications:

• Completion of relevant education or training as a Licensed Vocational Nurse (LVN), Nursing (RN), or related field of study from an accredited college, university or vocational/training school.
• If applicable, associated licensure/certification to education (i.e. LVN).
• 2 plus years of clinical experience.

Preferred Qualifications:

• Bachelor’s Degree in Nursing from an accredited school of professional nursing.
• 2 plus years of claims auditing or value-based care work.

For more information, visit www.jpshealthnet.org .

To view all job vacancies, visit www.jpshealthnet.org , www.jpshealthnet.org/careers ,or www.teamacclaim.org.

Who We Are

JPS Health Network is a $950 million, tax-supported healthcare system in North Texas. Licensed for 582 beds, the network features over 25 locations across Tarrant County, with John Peter Smith Hospital a Level I Trauma Center, Tarrant County's only psychiatric emergency center, and the largest hospital-based family medical residency program in the nation. The health network employs more than 7,200 people.

Acclaim Multispecialty Group is the medical practice group featuring over 300 providers serving JPS Health Network. Specialties range from primary care to general surgery and trauma. The Acclaim Multispecialty Group formed around a common set of incentives and expectations supporting the operational, financial, and clinical performance
outcomes of the network. Our goal is to provide high quality, compassionate clinical care for every patient, every time.

Why JPS?

We're more than a hospital. We're 7,200 of the most dedicated people you could ever meet. Our goal is to make sure the people of our community get the care they need and deserve. As community stewards, we abide by three Rules of the Road:

1. Own it.Everyone who wears the JPS badge contributes to our journey to excellence.
2. Seek joy.Every day, every shift, we celebrate our patients, smile, and emphasize positivity.
3. Don't be a jerk.Everyone is treated with courtesy and respect. Smiling, laughter, compassion - key components of our everyday experience at JPS.

When working here, you're surrounded by passion, diversity, and dedication. We look forward to meeting you!

#nursingfeaturedjob

Job Title:

CHART AUDITOR

Requisition Number:

46369

Employment Type:

Full Time

Division:

ACCLAIM ADMIN SERVICES

Compensation Type:

Salaried

Job Category:

Patient Care Support

Hours Worked:

M-F 8AM-5PM

Location:

Acclaim Magnolia

Shift Worked:

Day

Job Description:

The Chart Auditor will be responsible for performing clinical reviews to determine the accuracy of ICD-10 codes listed on forms from payors, performing interactive outreach for the Transition of Care program, pending outstanding patient orders, validating ED high utilization patient attribution, and reviewing gap in care reports to address outstanding patient health risks. This job involves accessing proprietary systems to audit medical records, accurately documenting findings, and providing forms to the clinic providers.

Essential Job Functions & Accountabilities:

• Reviews and interprets medical records and compares against forms for accuracy of presumed diagnoses.
• Documents decisions and rationale to justify review findings.
• Pend orders to address outstanding patient care gaps.
• Performs interactive outreach for patients discharged from Inpatient stays.
• Assists management with training any new Chart Auditor.
• Maintains current knowledge of clinical criteria guidelines to maintain a clinical license.
• Responsible for attending training and scheduled meetings to enhance skills and working knowledge of clinical policies, procedures, rules, and regulations.
• Actively cross-trains to perform reviews of multiple payor types and requirements and understand the documentation needs.
• Recommends, tests, and implements process improvements, new audit concepts, and technology improvements that will enhance production, quality, and client satisfaction.
• Reviews payor gap in care reports to validate patient medication adherence compliance.
• Validates and facilitates care management for high ED utilizing patients.
• Job description is not an all-inclusive list of duties and may be subject to change with or without notice. Staff are expected to perform other duties as assigned.

Qualifications:

Required Qualifications:

• Completion of relevant education or training as a Licensed Vocational Nurse (LVN), Nursing (RN), or related field of study from an accredited college, university or vocational/training school.
• If applicable, associated licensure/certification to education (i.e. LVN).
• 2 plus years of clinical experience.

Preferred Qualifications:

• Bachelor’s Degree in Nursing from an accredited school of professional nursing.
• 2 plus years of claims auditing or value-based care work.

Location Address:
200 W. Magnolia
Fort Worth, Texas, 76104
United States