CHART AUDITOR

Job Title: CHART AUDITOR

Requisition Number: 46369

Employment Type: Full Time

Division: ACCLAIM ADMIN SERVICES

Location: 200 W. Magnolia, Fort Worth, TX 76104, United States

JPS Health Network is a $950 million, tax-supported healthcare system in North Texas, licensed for 582 beds with over 25 locations across Tarrant County, including John Peter Smith Hospital (Level I Trauma Center), Tarrant County's only psychiatric emergency center, and the nation's largest hospital-based family medical residency program. The network employs more than 7,200 people. Acclaim Multispecialty Group is the medical practice group with over 300 providers serving JPS, offering specialties from primary care to general surgery and trauma, formed around common incentives supporting operational, financial, and clinical performance. The goal is to provide high quality, compassionate clinical care for every patient, every time. JPS emphasizes three rules: Own it, Seek joy, Don't be a jerk, fostering a culture of positivity, respect, and compassion.

About the role

The Chart Auditor will be responsible for performing clinical reviews to determine the accuracy of ICD-10 codes listed on forms from payors, performing interactive outreach for the Transition of Care program, addressing pending outstanding patient orders, validating ED high utilization patient attribution, and reviewing gap in care reports to address outstanding patient health risks. This role involves accessing proprietary systems to audit medical records, accurately documenting findings, and providing forms to clinic providers.

Responsibilities

• Reviews and interprets medical records and compares against forms for accuracy of presumed diagnoses.
• Documents decisions and rationale to justify review findings.
• Pend orders to address outstanding patient care gaps.
• Performs interactive outreach for patients discharged from Inpatient stays.
• Assists management with training any new Chart Auditor.
• Maintains current knowledge of clinical criteria guidelines to maintain a clinical license.
• Responsible for attending training and scheduled meetings to enhance skills and working knowledge of clinical policies, procedures, rules, and regulations.
• Actively cross-trains to perform reviews of multiple payor types and requirements and understand the documentation needs.
• Recommends, tests, and implements process improvements, new audit concepts, and technology improvements that will enhance production, quality, and client satisfaction.
• Reviews payor gap in care reports to validate patient medication adherence compliance.
• Validates and facilitates care management for high ED utilizing patients.
• Job description is not an all-inclusive list of duties and may be subject to change with or without notice. Staff are expected to perform other duties as assigned.

Qualifications

Required Qualifications:

• Completion of relevant education or training as a