Hospice Qapi RN

Job Description

Job Description

RN Chart Auditor

The duties of an RN chart auditor are to review medical records for accuracy, quality assurance, or billing and insurance purposes. The responsibilities include assessing medical records to decide whether there is a valid reason for treatment or denial of care and ensure that the quality of patient care abides by health care policies and standards.

Primary Responsibilities

• Review and audit medical records: examine patient charts to ensure completeness, accuracy and adherence to legal, regulatory, and institutional standards, including HIPAA, Medicare and Medicaid guidelines.

• Documentation improvement: provide feedback to healthcare staff, including physicians, nurses, home health aides to clarify or correct documentation issues.

• Reporting: prepare detailed audit reports highlighting deficiencies, trends, and recommendations for process improvements.

• Training and support: assist in training new hires on proper documentation and auditing procedures.

Education and Experience:

• Education:

• Graduate of an accredited registered nursing program

• Bachelor’s degree in Nursing preferred.

• Certified Hospice and Palliative Nurse (CHPN) certification preferred.

• Experience:

• Has minimum of one (1) year hospice nursing experience.

• Ability to work within an interdisciplinary setting

• Understanding of Hospice philosophy, principles of death/dying.

• 2 years of relevant experience in medical coding, clinical documentation or Medicare audits, ADR (Additional Documentation Requests), and appeals.

• Licensure, Registration and/or Certification

• Registered Nurse licensed by the New Jersey State Board of Nursing in accordance with N.J.S.A. 45:11-23 et seq. and N.J.A.C. 13:37.

• Valid drivers license and reliable transportation that is insured in accordance with New Jersey state requirements

• Satisfactory references from employers and/or professional peers.

• Satisfactory criminal background check.