OR Nurse Auditor (Hybrid)
R-57637
Discover Vanderbilt University Medical Center: Located in Nashville, Tennessee, and operating at a global crossroads of teaching, discovery, and patient care, VUMC is a community of individuals who come to work each day with the simple aim of changing the world. It is a place where your expertise will be valued, your knowledge expanded, and your abilities challenged. Vanderbilt Health is committed to an environment where everyone has the chance to thrive and where your uniqueness is sought and celebrated. It is a place where employees know they are part of something that is bigger than themselves, take exceptional pride in their work and never settle for what was good enough yesterday. Vanderbilt’s mission is to advance health and wellness through preeminent programs in patient care, education, and research.
Organization:
Periop Support Svc(Scheduling)
Job Summary:
Performs detailed audit of billed Perio-operative Services charges. Utilization of audit tools to ensure billing practices are consistent with clinical documentation.
.
POSITION HIGHLIGHTS:
• Hybrid work environment: 3 days remote / 2 days required in the office (Green Hills)
• Salaried position - 40 hours per week
• Autonomy
• No holidays
• Magnet-designated organization
• #1 ranked hospital in Nashville and Tennessee (U.S. News and World Report 2023-2024)
WHAT YOU WILL DO:
• Provide audits for all operating room surgical cases
• Preference card building
• Review billing for accuracy
• Coordinate interaction with OR clinical staff and various hospital department representatives to gather supporting information, documentation or clarification of any audit discrepancies
• Work as a team member with the OR staff and managers; materials management staff and Hospital Auditor to ensure proper documentation
• Serve as a nursing resource for staff when issues/needs are of a clinical nature
• Review medical records and interpret clinical information as needed to resolve issues identified by other staff members
• Communicate effectively with other staff members or patients/guarantor to insure their understanding of clinical information
WHAT YOU WILL NEED:
• State or compact license (TN license within 60 days of getting TN address even if compact license)
• Bachelor's degree (BSN highly preferred)
• 5 years of relevant experience (5 years of operating room nursing experience highly preferred)
KEY RESPONSIBILITIES
• Performs detailed audit of billed Peri-operative Services.
• Review documentation in support of OR charges billed to the patient for accuracy and reasonableness.
• Coordinate interaction with OR clinical staff and various hospital department representatives to gather supporting information, documentation or clarification of any audit discrepancies
• Work as a team member with the OR staff and managers; materials management staff and Hospital Auditor to ensure proper documentation.
• Serve as a nursing resource for staff when issues/needs are of a clinical nature.
• Review medical records and interpret clinical information as needed to resolve issues identified by other staff members.
• Communicate effectively with other staff members or patients/guarantor to insure their understanding of clinical information.
• Supervises day to day performance of staff through ongoing assessment and coaching to achieve goals. Contributes to formal evaluation of staff.
• Assess and assists OR Billers to utilize critical thinking skills in order to identify any process changes needed to help increase accuracy and efficiency of OR billing.
• Review and approved OR Billers timesheets.
• Assist with identifying and addressing first level of performance issues.
TECHNICAL CAPABILITIES
Our professional administrative functions include critical supporting roles in information technology and informatics, finance, administration, legal and community affairs, human resources, communications and marketing, development, facilities, and many more.
At our growing health system, we support each other and encourage excellence among all who are part of our workforce. High-achieving employees stay at Vanderbilt Health for professional growth, appreciation of benefits, and a sense of community and purpose.
Core Accountabilities:
Organizational Impact: Executes job responsibilities with the understanding of how output would affect and impact other areas related to own job area/team with occasional guidance. Problem Solving/ Complexity of work: Analyzes moderately complex problems using technical experience and judgment. Breadth of Knowledge: Has expanded knowledge gained through experience within a professional area. Team Interaction: Provides informal guidance and support to team members.
Core Capabilities :
Supporting Colleagues:- Develops Self and Others: Invests time, energy, and enthusiasm in developing self/others to help improve performance e 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:- 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: - 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: - 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:- 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.
Position Qualifications:
Responsibilities:
Certifications:
LIC-Registered Nurse - Licensure-Others
Work Experience:
Relevant Work Experience
Experience Level:
5 years
Education:
Bachelor's
This role offers the opportunity to make a meaningful impact within Vanderbilt Health, supported by a comprehensive benefits package which may include health, disability, retirement and/or wellness offerings to enhance your well-being and professional growth.
Vanderbilt Health is committed to fostering an environment where everyone has the chance to thrive and is committed to the principles of equal opportunity. EOE/Vets/Disabled.
Apply tot his job
Apply To this Job
Discover Vanderbilt University Medical Center: Located in Nashville, Tennessee, and operating at a global crossroads of teaching, discovery, and patient care, VUMC is a community of individuals who come to work each day with the simple aim of changing the world. It is a place where your expertise will be valued, your knowledge expanded, and your abilities challenged. Vanderbilt Health is committed to an environment where everyone has the chance to thrive and where your uniqueness is sought and celebrated. It is a place where employees know they are part of something that is bigger than themselves, take exceptional pride in their work and never settle for what was good enough yesterday. Vanderbilt’s mission is to advance health and wellness through preeminent programs in patient care, education, and research.
Organization:
Periop Support Svc(Scheduling)
Job Summary:
Performs detailed audit of billed Perio-operative Services charges. Utilization of audit tools to ensure billing practices are consistent with clinical documentation.
.
POSITION HIGHLIGHTS:
• Hybrid work environment: 3 days remote / 2 days required in the office (Green Hills)
• Salaried position - 40 hours per week
• Autonomy
• No holidays
• Magnet-designated organization
• #1 ranked hospital in Nashville and Tennessee (U.S. News and World Report 2023-2024)
WHAT YOU WILL DO:
• Provide audits for all operating room surgical cases
• Preference card building
• Review billing for accuracy
• Coordinate interaction with OR clinical staff and various hospital department representatives to gather supporting information, documentation or clarification of any audit discrepancies
• Work as a team member with the OR staff and managers; materials management staff and Hospital Auditor to ensure proper documentation
• Serve as a nursing resource for staff when issues/needs are of a clinical nature
• Review medical records and interpret clinical information as needed to resolve issues identified by other staff members
• Communicate effectively with other staff members or patients/guarantor to insure their understanding of clinical information
WHAT YOU WILL NEED:
• State or compact license (TN license within 60 days of getting TN address even if compact license)
• Bachelor's degree (BSN highly preferred)
• 5 years of relevant experience (5 years of operating room nursing experience highly preferred)
KEY RESPONSIBILITIES
• Performs detailed audit of billed Peri-operative Services.
• Review documentation in support of OR charges billed to the patient for accuracy and reasonableness.
• Coordinate interaction with OR clinical staff and various hospital department representatives to gather supporting information, documentation or clarification of any audit discrepancies
• Work as a team member with the OR staff and managers; materials management staff and Hospital Auditor to ensure proper documentation.
• Serve as a nursing resource for staff when issues/needs are of a clinical nature.
• Review medical records and interpret clinical information as needed to resolve issues identified by other staff members.
• Communicate effectively with other staff members or patients/guarantor to insure their understanding of clinical information.
• Supervises day to day performance of staff through ongoing assessment and coaching to achieve goals. Contributes to formal evaluation of staff.
• Assess and assists OR Billers to utilize critical thinking skills in order to identify any process changes needed to help increase accuracy and efficiency of OR billing.
• Review and approved OR Billers timesheets.
• Assist with identifying and addressing first level of performance issues.
TECHNICAL CAPABILITIES
Our professional administrative functions include critical supporting roles in information technology and informatics, finance, administration, legal and community affairs, human resources, communications and marketing, development, facilities, and many more.
At our growing health system, we support each other and encourage excellence among all who are part of our workforce. High-achieving employees stay at Vanderbilt Health for professional growth, appreciation of benefits, and a sense of community and purpose.
Core Accountabilities:
Organizational Impact: Executes job responsibilities with the understanding of how output would affect and impact other areas related to own job area/team with occasional guidance. Problem Solving/ Complexity of work: Analyzes moderately complex problems using technical experience and judgment. Breadth of Knowledge: Has expanded knowledge gained through experience within a professional area. Team Interaction: Provides informal guidance and support to team members.
Core Capabilities :
Supporting Colleagues:- Develops Self and Others: Invests time, energy, and enthusiasm in developing self/others to help improve performance e 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:- 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: - 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: - 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:- 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.
Position Qualifications:
Responsibilities:
Certifications:
LIC-Registered Nurse - Licensure-Others
Work Experience:
Relevant Work Experience
Experience Level:
5 years
Education:
Bachelor's
This role offers the opportunity to make a meaningful impact within Vanderbilt Health, supported by a comprehensive benefits package which may include health, disability, retirement and/or wellness offerings to enhance your well-being and professional growth.
Vanderbilt Health is committed to fostering an environment where everyone has the chance to thrive and is committed to the principles of equal opportunity. EOE/Vets/Disabled.
Apply tot his job
Apply To this Job