Medical Staff Auditor

Company: Vanderbilt University Medical Center
Location: Baton Rouge
Posted on: January 27, 2023

Job Description:

Medical Staff Auditor - 2213999 **Job** : Medical Coding and Billing **Primary Location** : Work from Home **Organization** : Provider Credentialing 30 200607 **Shift:** : First Shift **Description** **Medical Staff Auditor - 100% REMOTE** **JOB SUMMARY:** Ensures credentialing and privileging activities comply with requirements of regulatory and accrediting agencies including the Centers for Medicare/Medicaid Services, the Joint Commission, and the National Committee for Quality Assurance, federal and state laws and delegated credentialing agreements independently. Executes the Medical Staff Office Quality Assurance Program. **KEY RESPONSIBILITIES:** + Audits credentials files and verifies information entered in information systems. + Maintains and analyzes quality data, identifies trends, and recommends corrective actions. + Coordinates external audit engagements and responding to complex inquiries. + Prepares and submits material for external audits and Corrective Action Plans. + Serves as primary contact for VHAN. + The responsibilities listed are a general overview of the position and additional duties may be assigned. **TECHNICAL CAPABILITIES:** _DISCRETION & PRIVACY (ADVANCED):_ - The ability to use and keep information confidential in a secure setting. _DATA ENTRY (ADVANCED):_ - The ability to transcribe information from the original source into an electronic system according to written and verbal instructions efficiently and accurately. _ANALYTICAL SKILLS (ADVANCED):_ - The process of identifying, evaluating, interpreting and organizing data. It includes sorting through data to identify patterns and establish relationships for decision making. _CVO POLICIES AND PROCEDURES (INTERMEDIATE):_ - Knowledge, adherence and application of CVO policies and procedures. _PROCESS DEVELOPMENT (ADVANCED):_ - Identifies, analyzes and improves upon existing business processes for optimization and to meet standards of quality. **CORE ACCOUNTABILITIES:** + Organizational Impact: Independently performs non-routine tasks that significantly impact team and other related teams. + Problem Solving/ Complexity of work: Gathers and analyzes data to solve problems that arise with little or no precedent. + Breadth of Knowledge: Applies advanced job knowledge and has developed a breadth of skills in other areas. + Team Interaction: Serves as a lead for the team by providing expertise and guidance to team members. **CORE CAPABILITIES:** SUPPORTING COLLEAGUES (S4): + - Develops Self and Others: Invests time, energy and enthusiasm in developing self/others to help improve performance and gain knowledge in new areas. + - Builds and Maintains Relationships: Maintains regular contact with key colleagues and stakeholders using formal and informal opportunities to expand and strengthen relationships. + - Communicates Effectively: Recognizes group interactions and modifies one's own communication style to suit different situations and audiences. DELIVERING EXCELLENT SERVICES (S4): + - Serves Others with Compassion: Seeks to understand current and future needs of relevant stakeholders and customizes services to better address them. + - Solves Complex Problems Approaches problems from different angles; Identifies new possibilities to interpret opportunities and develop concrete solutions. + - Offers Meaningful Advice and Support: Provides ongoing support and coaching in a constructive manner to increase employees' effectiveness. ENSURING HIGH QUALITY (S4): + - Performs Excellent Work: Engages regularly in formal and informal dialogue about quality; directly addresses quality issues promptly. + - Ensures Continuous Improvement: Applies various learning experiences by looking beyond symptoms to uncover underlying causes of problems and identifies ways to resolve them. + - Fulfills Safety and Regulatory Requirements: Understands all aspects of providing a safe environment and performs routine safety checks to prevent safety hazards from occurring. MANAGING RESOURCES EFFECTIVELY (S4): + - Demonstrates Accountability: Demonstrates a sense of ownership, focusing on and driving critical issues to closure. + - Stewards Organizational Resources: Applies understanding of the departmental work to effectively manage resources for a department/area. + - Makes Data Driven Decisions: Demonstrates strong understanding of the information or data to identify and elevate opportunities. FOSTERING INNOVATION (S4): + - Generates New Ideas: Proactively identifies new ideas/opportunities from multiple sources or methods to improve processes beyond conventional approaches. + - Applies Technology: Demonstrates an enthusiasm for learning new technologies, tools, and procedures to address short-term challenges + - Adapts to Change: Views difficult situations and/or problems as opportunities for improvement; actively embraces change instead of emphasizing negative elements. **Basic Qualifications** High School Diploma or GED (or equivalent experience) and 5 years relevant experience **Licensure, Certification, and/or Registration (LCR):** **Physical Requirements/Strengths needed & Physical Demands:** + Sedentary category requiring exertion up to 10 lbs. of force occasionally and uses negligible amounts of force to move objects. Sedentary work involves sitting most of the time. **Movement** + Occasional: Standing: Remaining on one's feet without moving. + Occasional: Walking: Moving about on foot. + Occasional: Lifting under 35 lbs: Raising and lowering objects under 35 lbs from one level to another + Occasional: Carrying under 35 lbs: Transporting an object holding in hands, arms or shoulders, with help of coworkers or assistive device. + Occasional: Push/Pull: Exerting force to move objects away from or toward. + Occasional: Reaching above shoulders: Extending arms in any direction above shoulders. + Frequent: Sitting: Remaining in seated position + Frequent: Reaching below shoulders: Extending arms in any direction below shoulders. + Frequent: Fingering: Picking, pinching, gripping, working primarily with fingers requiring fine manipulation. + Frequent: Bimanual Dexterity: Requiring the use of both hands. **Sensory** + Continuous: Communication: Expressing or exchanging written/verbal/electronic information. + Continuous: Auditory: Perceiving the variances of sounds, tones and pitches and able to focus on single source of auditory information + Continuous: Vision: Clarity of near vision at 20 inches or less and far vision at 20 feet or more with depth perception, peripheral vision, color vision. + Continuous: Smell: Ability to detect and identify odors. **Environmental Conditions** + Occasional: Chemicals and Gasses: Medications, cleaning chemicals, oxygen, other medical gases used in work area. **Req ID:** 2213999 Vanderbilt University Medical Center is committed to principles of equal opportunity and affirmative action.

Keywords: Vanderbilt University Medical Center, Baton Rouge , Medical Staff Auditor, Accounting, Auditing , Baton Rouge, Louisiana