Clinical Auditor

Tenet Healthcare Corp

Detroit, MI

JOB DETAILS
SKILLS
Accounting Software, Ambulatory Care, Analysis Skills, Auditing, Billing, BrassRing, Cancer, Cardiology, Cerner, Charge Capture, Clinical Study Publications, Critical Care, Documentation, E Programming Language, Emergency Medicine, Federal Laws and Regulations, Flexible Spending Accounts, Foundation Grants, Healthcare, Hospital, Hospital Administration, Insurance, Life Insurance, Medical Billing, Medical Records, Medical Treatment, Negotiation Skills, Nursing, Obstetrics and Gynecology, Outpatient Care, Patient Care, Process Improvement, Registered Nurse (RN), Regulations, Standards of Care, State Laws and Regulations, Team Player, Trend Analysis, Vision Plan
LOCATION
Detroit, MI
POSTED
5 days ago

DMC Sinai-Grace Hospital is committed to providing exceptional patient care in a supportive and collaborative environment. As a member of our team, you will have the opportunity to work with advanced technology and be part of a healthcare community dedicated to making a positive impact on the lives of our patients.

Benefit Statement:

At Tenet Healthcare, we understand that our greatest asset is our dedicated team of professionals. That's why we offer more than a job - we provide a comprehensive benefit package that prioritizes your health, professional development, and work-life balance. The available plans and programs include:

  • Medical, dental, vision, and life insurance
  • 401(k) retirement savings plan with employer match
  • Generous paid time off (PTO)
  • Career development and continuing education opportunities
  • Health savings accounts, healthcare C dependent flexible spending accounts
  • Employee Assistance program, Employee discount program
  • Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder C childcare, auto C home insurance.

Note: Eligibility for benefits may vary by location and is determined by employment status

Job Summary

Under limited direction and according to established policies and procedures conducts audits of hospital bills and medical records. Ensures documented charges are correctly billed and billed charges are documented in the medical record. Corrects billing errors in the Patient Accounting system and in some cases, the Cerner system. Identifies, reports and recommends actions to improve charge capture processes. Identifies new services and technology in the clinical setting and facilitates establishment of new charges. Conducts in-service training for hospital personnel to ensure understanding of the importance of effective charge capture and documentation of services performed. Conducts complex reviews of departmental processes which include registration, clinical activities, documentation and charge capture. Identifies opportunities to maximize billing in accordance with federal and state regulations. Safeguards the assets of the DMC, advocates appropriate levels of internal control and promotes operating effectiveness and efficiency. Defend the hospitals revenue through research, documentation and negotiation by participating in and acting as a content expert for the hospital in audits conducted by third parties including, but not limited to, Blue Cross Catastrophic audits; HOPP audits; MPRO audits and all commercial insurance audits. Provides both clinical and technical/billing expertise and acts as liaison and resource for user departments. Analyzes results, identifies trends and patterns and prepares monthly statistical and narrative reports for various levels of hospital and corporate management. [BRASSRING IMPORT 11/11/16]

Qualifications:

Minimum Qualifications

1.Bachelor's Degree in Nursing.

2.Licensed Registered Nurse in the State of Michigan.

  1. Three years of patient care experience in a hospital as a Registered Nurse, at least one of which should be in a critical patient care specialty area such as I.C.U., E.R. or O.R.

4.Charge audit or similar experience preferred.

  1. One year experience as a Clinical Auditor.

Facility Description

DMC Sinai-Grace Hospital is DMC's largest hospital, offering a comprehensive heart center, cancer care, gerontology, emergency medicine, obstetrics/gynecology and cosmetic services. Sinai-Grace's joint replacement program features a revolutionary minimally invasive knee and hip replacement surgery that attracts patients from all over the country. Sinai-Grace operates more than 21 outpatient care sites and ambulatory surgery centers throughout Wayne and Oakland Counties and is one of 10 hospitals in the nation to be awarded a Robert Wood Johnson Foundation grant to help set the standards of cardiac care for hospitals and physicians throughout the nation.

EEO Statement

Employment practices will not be influenced or affected by an applicant's or employee's race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status.

Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.

Tenet participates in the E-Verify program. Follow the link below for additional information.

E-Verify: http://www.uscis.gov/e-verify

The employment practices of Tenet Healthcare and its companies comply with all applicable laws and regulations

Job: HIM/Coding/Transcription

Primary Location: Detroit, Michigan

Facility: DMC Sinai-Grace Hospital

Job Type: Full Time

Shift Type: Day

Employment practices will not be influenced or affected by an applicant's or employee's race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.

Tenet participates in the E-Verify program. Follow the link below for additional information.

E-Verify: http://www.uscis.gov/e-verify

The employment practices of Tenet Healthcare and its companies comply with all applicable laws and regulations.

2606001999

About the Company

T

Tenet Healthcare Corp

Tenet Healthcare Corporation is a diversified healthcare services company with 115,000 employees united around a common mission: to help people live happier, healthier lives. Through its subsidiaries, partnerships and joint ventures, including United Surgical Partners International, the Company operates general acute care and specialty hospitals, ambulatory surgery centers, urgent care centers and other outpatient facilities. Tenet's Conifer Health Solutions subsidiary provides technology-enabled performance improvement and health management solutions to hospitals, health systems, integrated delivery networks, physician groups, self-insured organizations and health plans.

Since 2003, Tenet's Commitment to Quality has improved the quality of medical care and patient safety at its hospitals and other businesses by evaluating processes and promoting best practices. As the world in which Tenet operates continues to change, Tenet's Commitment to Quality will remain focused on quality, the growing quality gap relative to top performers in the industry, and the fact that payers and employees use quality as a distinguishing factor. Visit the Quality Care page for more information.

Tenet has taken the lead in addressing the needs of the uninsured through its Compact With Uninsured Patients. Established in 2003, the Compact focuses on treating patients without insurance fairly and with respect during and after their treatment, regardless of their ability to pay. Tenet also is committed to working with its patients through financial counseling and alternative payment options.
COMPANY SIZE
10,000 employees or more
INDUSTRY
Healthcare Services
WEBSITE
http://jobs.tenethealth.com

Similar Job Searches