CHART AUDITOR

Acclaim Health; Fort Worth (TX); On-site; USD 55,000 - 75,000; Full time

Job summary

Acclaim Administrative Services in Fort Worth, TX, seeks a Chart Auditor to review ICD-10 coding accuracy and audit medical records. You will perform outreach for the Transition of Care program, validate ED usage data, and document results to guide clinic providers.

The role requires 2+ years of clinical experience with LVN/RN education and active licensure. On-site hours are typically 8 AM–5 PM, Monday through Friday.

Qualifications

• Completion of LVN/RN or related field from an accredited institution.
• 2+ years of clinical experience.
• Licensure as LVN or RN per state requirements.

Responsibilities

• Review medical records for accuracy of ICD-10 codes against forms from payors.
• Perform outreach for Transition of Care program and address care gaps.
• Document findings and support care management for high ED utilizers.

Skills

ICD-10 coding

Medical records review

Clinical auditing

Education

LVN/RN degree

RN 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.

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

• Own it. Everyone who wears the JPS badge contributes to our journey to excellence.
• Seek joy. Every day, every shift, we celebrate our patients, smile, and emphasize positivity.
• 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!

For more information, visit www.jpshealthnet.org .

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

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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

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.

Location Address

200 W. Magnolia
Fort Worth, Texas, 76104
United States