Data Quality Specialist

Company: Aspen Valley Hospital
Location: Glenwood Springs
Posted on: January 15, 2022

Job Description:

Company Overview: Embrace the adventure of a career at Aspen Valley Hospital . Aspen Valley Hospital is a twenty-five-bed community hospital that represents the best of two worlds - the warmth and friendliness of a small town and the technical expertise of a major medical center. Our award-winning hospital, nestled in the heart of Aspen, CO, includes a team of more than 500 people dedicated to making a difference for our patients, families, and community. Nationally we are recognized for providing some of the most exceptional patient care of any hospital across the country. AVH supports vaccinations as the evidence-based and most effective means for our community and country to put COVID-19 behind us and to avoid unnecessary hospitalizations and deaths. In order to better care for our community, as of 10/31/21, AVH requires COVID-19 Vaccination for all Staff. This Position Offers: Highly competitive pay, comprehensive benefits package (including generous PTO, health insurance within your first 30 days, retirement), being part of a very cohesive & supportive team, and four of North America's top ski resorts at your doorstep. Job Overview: Responsible for the accuracy of medical record documentation, including but not limited to: billing review to assess appropriate capturing of charges based on medical record documentation, review of dictated and handwritten entries in medical record to assess for compliance with regulatory and accrediting agencies, coordinating the CHA patient population discharge data program, coordinating payer audits, and assisting with medical record functions as necessary. Primary Scope of Responsibilities: * Reviews billing records in comparison with medical record documentation * Trends and reports results of charge capture reviews for department/administration action * Reviews medical record documentation for compliance with regulatory and accreditation requirements * Trends and reports results of medical record reviews for medical staff action * Prepares monthly discharge data for reporting to CHA * Demonstrates purposeful service excellence through exceeding patient and coworker expectations. * Represents the department/hospital as a dedicated, courteous, and responsive employee * Records pertinent documentation in accordance with regulatory requirements, professional standards and hospital policy. * Adheres to federal, state and hospital rules and regulations concerning HIPAA privacy and security. * Follows Hospital compliance plan and policies, including the Code of Conduct. * Participates in required training for compliance related activities (HIPAA, Compliance, Patient Safety, TJC, etc.) * Reviews patient account charges in comparison with medical record documentation to determine if charges are substantiated, within bill drop/hold time requirements. * Trends and prepares monthly reports of review results, distributes to department directors and Compliance Committee members, and assists department directors in understanding those trends. * Receives and responds to payor requested audits; prepares discrepancy or agreement paperwork based on results of said audits for payor and CFO. * Prepares and submits monthly discharge data for reporting to CHA; edits incorrect or missing information as needed * Reviews medical record documentation for compliance with regulatory and accrediting agency requirements, including but not limited to: * timeliness of documents (History and Physical, Discharge Summary, Consults) * completeness of documents (all elements required are met) * legibility of documentation * Prepares monthly reports of said reviews for medical staff action * Demonstrates responsibility and accountability for own professional decision making and professional growth. * Participates and contributes to departmental meetings and activities. Minimum Qualifications & Requirements: * High School Grade or GED equivalent * 2 years experience in data quality position in acute care hospital * 2 years experience in billing, claims, pay or relations for hospitals * RHIT/RHIA certification, preferred * CMAS certification, preferred Benefits & Compensation: Hire-in rates of pay are based upon the relevance of years of experience, education and certifications. Our talent acquisition team will help you understand how your direct experience will be considered. Pay range for new hires: $21.07 - $27.43/hr Our comprehensive benefits package includes generous paid time off, health insurance within your first 30 days, and retirement, which can be viewed here .

Keywords: Aspen Valley Hospital, Snowmass , Data Quality Specialist, Other , Glenwood Springs, Colorado