Description
General Summary of Position
MedStar Health is looking for a Surgical Services Auditor to join our team at MedStar Southern Maryland Hospital Center!
The Surgical Services Auditor is the auditor and charge entry coordinator for Perioperative Services, Endoscopy, Cardiology, Interventional Radiology, and all other revenue generating areas, as directed promptly. Supports regulatory compliance as well as the revenue cycle to ensure each case record is accurate and all supply items have been assigned the appropriate charge. Under the direction of the Business Operations Manager, the Surgical Service Auditor will be responsible for reviewing clinical documentation within all Perioperative and Procedural departments to audit for charging accuracy, regulatory compliance, and quality outcomes. The Surgical Service Auditor will partner with service line managers, clinic/procedural schedulers, Supply Chain associates and other support staff.
Join one of the largest healthcare systems in the Baltimore-Washington metro region, also recognized as one of the "Healthiest Maryland Businesses". Apply today and learn how MedStar Health can be your next great career move!
Primary Duties:
Reviews clinical documentation to determine if charging for the procedure, supplies, implants, recovery, and any other associated charges are documented accurately. Participates in assigning and reviewing HCPC and charge codes assigned to implants and supplies. Reviews patient records for use of supplies not appearing on the billing document. Initiates the build process for items that are not built into the EMR.
Participates in feedback process with nurse managers and clinicians to ensure documentation is corrected promptly. Ability to work in multiple software applications to collaborate with supply chain and billing compliance to audit and identify the correct pricing and charging of supplies and implants. Works with vendors to obtain pricing/product information to maintain an accurate item master. Assigns a charge description master (CDM) number to non-stock specialty items and implants.
Supports the implementation and accuracy of new contracts to ensure accurate pricing is maintained in the EMR. Reviews vendor invoices for specialty items and implants for corresponding cases to ensure accuracy of patient charges for billing documents. Assesses appropriate clinical documentation. Partners with service line clinic and procedural schedulers, managers, resource nurse or supply coordinator, and revenue control specialists to develop a working relationship and effective work group for problem solving.
Collaborates with Patient Financial Services to resolve bill edit corrections for plausible charge correction. Oversees the ‘un-finalized' case reports and any other reports while working with clinical staff to complete all documentation both timely and accurately. Knowledgeable of Hospital policies and organizational identified quality initiatives; incorporates this knowledge into audits to help drive documentation compliance in partnership with unit leadership.
Reviews monthly spending while identifying opportunities to reduce expenses. Develops and maintains clinical knowledge of areas auditing, to maintain a clear understanding of what should be found within documentation. Provides OR information system training for clinical and non-clinical staff. Provides OR system administration and hardware troubleshooting support as needed
Qualifications:
Associate degree or 1-3 years formal training in a related surgical services field.
Familiarity with OR information systems, supply chain management information systems, procedures and supplies used in general surgery, and surgical and procedural subspecialties.
1-2 years of progressively more responsible experience as a Surgical Technologist, LPN or as a biller with surgical and procedural experience preferred.
CPB (Certified Medical Biller) or LPN (Licensed Practical Nurse - State Licensure) or CST (Certified Surgical Technologist) within 180 days preferred.
This position has a hiring range of $65,062 - $117,291
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