Medical Staff Auditor - 100% REMOTE

Company: Vanderbilt University Medical Center
Location: Lansing
Posted on: November 24, 2022

Job Description:

Medical Staff Auditor - 100% REMOTE - 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, Lansing , Medical Staff Auditor - 100% REMOTE, Healthcare , Lansing, Michigan