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Internal Quality Auditor

Spotlight Preferred Diversity Focus
AMN Healthcare Revenue Cycle Solutions
United States
10 days ago

Description

The Internal QA Auditor/Mentor will have the primary responsibility of being an expert resource to the Director of Internal Quality Review, AMN Revenue Cycle Solutions (RCS) Leaders and Coding Consultants.  Their main responsibility will be to facilitate the internal audit process for all RCS consultants across all service lines. In this role, the auditor is accountable to Clients, RCS consultants and RCS leadership to ensure quality outcomes.  Serves as Subject Matter Expert (SME) (internal & external) related to the HIM coding area of expertise to Clients, RCS consultants and Leadership. 



Requirements

Job Tasks: 

  • Audits medical record documentation to identify inaccurate coding services; prepares reports of recommendations and presents findings to medical coders to provide education on accurate coding practices and compliance issues as necessary.
  • Assist coding staff with complex queries
  • Works with management on service and process improvements and policy development.
  • Reviews audits with the Director Internal Quality on any identified trends and areas in need of auditing or training for coding consultants
  • Follows all appropriate Federal and State regulatory requirements and guidelines applicable to health care plans or as documented in Client policies and procedures
  • Works assigned auditing projects to completion; organized and meets deadlines
  • Work collaboratively with the Director Internal QA and RCS WFM to plan and conduct compliance, clinical or revenue focused audits designed to identify control gaps, process inefficiencies and regulatory adherence.
  • Performs audits on RCS Advisory and billable Auditor Consultants on a regular cadence established by RCS Executive Director and Director Internal Quality
  • Mentors RCS consultants who are under a performance improvement plan to ensure their understanding of education provided
  • At Client request reviews consultants cases concurrently to ensure accuracy of work to prevent re-work and assists with Client questions related to particular service line
  • Provides timely communication in response to Client related issues as well as any internal audit related questions to ensure a successful experience for the Client and RCS Consultants
  • Proactively takes action to ensure all client commitments are met
  • Performs focused audits as requested by clients to ensure RCS consultants are following appropriate industry guidelines and client guidelines
  • Completion and follow through of all processes entailed in audits and client obligations
  • Completes all assigned audits by the 5th of the following month
  • Auditor continuously meets productivity expectations specific to the area they are auditing 
  • Respond to management within 12 hours unless otherwise determined by manager
  • Auditor to adhere to ‘Standard Terminology for Auditor Recommendations’ Policy
  • Update systems with all necessary audit information within 24 hrs of an audit being finalized
  • Performs miscellaneous job-related duties, as assigned. 
  • Communicates escalations as needed to Senior Manager, Internal Quality
  • Develops and maintains supportive and positive relationships with all employees
  • Adheres to the compliance and quality program

Travel – 0%

Exemption Status:  Non Exempt

Job Information

  • Job ID: 60806434
  • Location:
    United States
  • Position Title: Internal Quality Auditor
  • Company Name: AMN Healthcare Revenue Cycle Solutions
  • Work Setting: Consultant/Vendor,Other,Remote
  • Job Function: Auditing,
    QA QI QM
  • Career Level: Experienced (non-manager)
  • Job Type: Full-Time
  • Job Duration: Indefinite
  • Min Education: Bachelors
  • Min Experience: 7-10
  • Required Travel: None
  • Required Credentials: AHIMA,RHIA,RHIT,CCS,CCS-P

Please refer to the company's website or job descriptions to learn more about them.

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