Audit Specialist - Full Time Job at Titus Regional Medical Center
Job: Audit Specialist
Classification: Hourly/Non-Exempt
Job Category: 5 Administrative Support Workers
Position Summary
The Audit Specialist assists in operations of Quality and Risk Management programs and Medical Staff Credentialing activities including review of medical records for routine and focused review activities; performs audits for quality monitoring activities, risk management activities, and credentialing activities; and assists in Joint Commission accreditation activities.
Essential Functions
- Reviews medical records and collects data for medical staff performance profile and quality improvement program activities.
- Reviews medical records to identify quality improvement opportunities and for risk management activities.
- Assists in preparation of QI and Risk Management reports.
- Assists in investigation of undesirable events that may represent potential liability to the hospital or other providers of care.
- Collects data which can be utilized in identifying and minimizing risk exposure.
- Assists with Medical Staff credentialing activities.
- Collects data for use with credentialing activities.
- Performs case review for routine and focused quality and credentialing matters.
- Assists in measures taken to ensure compliance with Joint Commission standards.
- Keeps Quality Management Director aware of Quality Improvements, Risk, and Medical Staff matters.
- Handles patient post discharge/treatment-based complaints and directs inquiries to appropriate management for follow up and resolution.
- Maintains customer complaint log to meet regulatory and Joint Commission standards.
- Demonstrates proficiency in customer service skills and conflict resolution when assisting customers with complaints.
- Demonstrates skill in creating spreadsheets and resources for communicating quality initiative actions.
- Interacts effectively with physicians, department managers, other healthcare workers, patients/families, and the public.
- Works with sensitive confidential matters while maintaining strict confidentiality.
- Demonstrates knowledge of various fields and specialties of healthcare.
- Adheres to and follows all patient experience initiatives.
- Reports to and departs from work on time and as scheduled.
- Performs other duties as assigned.
- Must be able to deal with stress while maintaining composure.
- Follows and adheres to TRMC vaccine policy(s) mandated by the Centers for Medicare & Medicaid Services (CMS).
Work Experience
- Five years’ experience in hospital nursing as an RN and peer review experience preferred.
- Prior knowledge of Joint Commission standards preferred.
Education
- Graduate of professional nursing preferred.
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