AUDIT INTEGRITY - AUDIT SPECIALIST

Posted 7 Days Ago
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83404, Idaho Falls, ID, USA
In-Office
Junior
Other
The Role
Processes external and internal audits, reviews medical records, validates data, and prepares reports on quality measures and payment compliance. The specialist analyzes trends, identifies improvement opportunities, supports regulatory compliance, trains staff on protocols, presents outcomes, resolves data and process issues, and manages audit-related projects through completion. The role requires medical terminology knowledge, familiarity with regulatory guidelines and revenue cycle processes, accurate database work, strong communication, and the ability to meet competing deadlines.
Summary Generated by Built In

Mountain View Hospital is looking for an Audit Specialist to join our team!

JOB SUMMARY:

The Audit Specialist will be responsible for processing external audits, including specialized or focused audits and projects. The individual will also be responsible for tracking and reporting of internal audit schedules and results including analyzing and reporting data for both quality measures and payment. The Audit Specialist will work directly with the Medical Auditor and Management team to ensure audits are conducted in accordance with Federal and State regulatory guidelines.

BENEFITS:

Taking care for our community starts with taking care of our own team. Mountain View Hospital is proud to offer its employees competitive and comprehensive benefit packages. Benefits include:

  • Medical, Dental and Vision Insurance
  • Paid Time Off (vacation, holidays and sick days) and Medical Paid Time Off
  • Retirement Plans (401K with up to 6% match)
  • Earned Quarterly Bonus Program
  • Education Reimbursement Program
  • Discount for medically necessary procedures performed at Mountain View Hospital and Idaho Falls Community Hospital

Please note benefits are based on eligibility according to full-time, part-time or PRN status classification.

DUTIES AND RESPONSIBILITIES:

  1. 1. Performs reviews of medical records, summarizes the findings and accurately enters information into databases as specified.
    2. Solves problems with regard to unique record or process issues.
    3. Tracks and validates data accuracy and timeliness in accordance with established guidelines.
    4. Compiles data into reports to analyze trends and patterns to assist in the identification of improvement activities and reports information to the appropriate departments, committees or individuals in relation to established goals.
    5. Works with various departments to assist them in being compliant with payment guidelines and quality measures
    6. Helps train clinicians and other staff on protocols.
    7. Participates in presentations to educate staff on outcomes and new or changing protocols and collaborates with the clinical team to use outcome data in education.
    8. Actively participates in problem identification and resolution and coordinates resolution between the appropriate parties.
    9. Accurately interprets and follows frequently changing data definitions and guidelines.
    10. Takes ownership of projects, researches data and follows through with detailed action plans to completion.
    11. Maintains a good working relationship

About Mountain View:

Mountain View Hospital and our 29 affiliate clinics are committed to providing compassionate, cutting edge care to our patients. We serve the entire Snake River Valley – all the way from Pocatello to Rexburg. Our medical capabilities span everything from wound care to urgent care, oncology to neurology, physical therapy to speech therapy, a Level III NICU, robust robotic surgery department and a continuously expanding rural health practice.

Our work environment is mission driven, people-centric and supportive. It is what sets apart and makes people excited to come to work each day. If you are looking for a career where you can make a difference in your community, we invite you to apply.

Qualifications

Education/Certification: High School Diploma or GED. CPC certification not required, but preferred. Knowledge of medical terminology, regulatory guidelines and revenue cycle.

Experience: 1-3 years of medical experience.

Equipment/Technology: Proficient computer skills, to include the navigation of several electronic databases. Knowledge of Microsoft Excel and Word.

Language/Communication: Excellent written and verbal communication skills, demonstrated ability to work independently, show initiative, and meet established goals and deadlines.

Mathematical Skills: Basic understanding of math and concepts to calculate percent of accuracy and deficiencies.

Mental Capabilities: Can concentrate for long periods of time in order to complete assigned tasks with a better than average attention span in order to listen, read and remember verbal and written instructions.

Interpersonal: Contributes toward effective, positive working relationships with internal and external colleagues. Demonstrates cooperation, flexibility, reliability, and dependability in all daily work activities, and a willingness to collaborate with others for the good of the organization

Performance: Can work well under pressure and meet multiple and competing deadlines. Hold oneself to high standards and professionalism

Skills Required

  • High school diploma or GED
  • Knowledge of medical terminology
  • Knowledge of regulatory guidelines
  • Knowledge of revenue cycle processes
  • One to three years of medical experience
  • Proficiency with computers and multiple electronic databases
  • Knowledge of Microsoft Excel and Microsoft Word
  • Excellent written and verbal communication skills
  • Ability to work independently, show initiative, and meet goals and deadlines
  • Basic math skills, including calculating accuracy percentages and deficiencies
  • Ability to concentrate for extended periods and follow verbal and written instructions
  • Ability to collaborate effectively with internal and external colleagues
  • CPC certification
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The Company
HQ: Idaho Falls, ID
1,298 Employees
Year Founded: 2002

What We Do

Mountain View Hospital is a physician-owned facility in Idaho Falls committed to providing compassionate, cutting-edge care. Serving the Snake River Valley from Pocatello to Rexburg, the hospital and its 29 affiliate clinics offer a wide range of services, including wound care, urgent care, oncology, neurology, physical and speech therapy, and a Level III NICU, focusing on making healthcare more personal and affordable.

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