Audit & Utilization RN Position Available In Cocke, Tennessee

Audit & Utilization

RN 4.7 4.7

out of 5 stars 222 Heritage Boulevard, Newport, TN 37713 Seeking a nurse for an Audit and Utilization Review position with Smoky Mountain Home Health and Hospice in Newport, TN; for the purpose of quality control of charting, coding and chart audits. Smoky Mountain is a locally owned home health and hospice company with 7 offices providing care to patients across 13 East Tennessee counties.

QUALIFICATIONS

A Registered Professional or Licensed Nurse, currently licensed in Tennessee. Have good working knowledge or be able to attain a good working knowledge of chart audits, Medicare and Medicaid guidelines as it pertains to Home Health care, Hospice care and coding. Good working knowledge of Home Health and Hospice documentation.

Certification:

Home Care Coding Specialist-Diagnosis (HCS-D)

Certification:

Home Care Coding Specialist-Hospice (HCS-H)

JOB DESCRIPTION

Review medical records within the time limit set by the Supervisor. Send back correspondence to the field staff as required for corrections. Maintain a daily system of providing timely and accurate information required for billing and/or regulation purposes. Participate in on-call when needed. Utilize Medicare/Medicaid and Private Insurance guidelines when auditing. Prepare and/or review transfer summaries on Agency transferred patients entering a hospital, nursing home or other agency within stated timeframes. Prepare and/or review admission, 60-90 day and discharge audits on assigned patients. Keeps ongoing contact with patient care staff and orients/teaches as needed with the assistance of the Staff Education Coordinator and Supervisor. Able to communicate effectively. Prepares and/or reviews chart information for additional data requisitions, denials and reconsiderations from Intermediary or any other agency asking for information as assigned by the Supervisor per SMHH&H policies (may include attorneys, family members, insurance companies, DHS, APS).

Job Type:

Full-time Benefits:

401(k) Dental insurance Disability insurance Employee assistance program Health insurance Life insurance Vision insurance

Schedule:

8 hour shift Monday to

Friday Work Location:

In person