Job Description

Job Location Hammond, LA 70403 Position Type Full Time Job Shift Any

Definition and Role

A Licensed Practical Nurse-Clinical Auditor engages in systematic chart review, analysis, and abstraction of data from multiple sources, systems, and collaboration with interdisciplinary teams. This role is responsible for the input of information into database systems and the deployment and correct use of related applications and software. This person will report to the Director of Strategic Initiatives.

**This is a hybrid role open to South Louisiana and Mississippi residents only and requires periodic in-office visits to our Hammond, Louisiana office.

Job Responsibilities and Duties

• Reviews and interprets medical records and compares against criteria to determine appropriateness and reasonableness of care; apply critical thinking and decision-making skills to determine if the medical record documentation supports the need for service while maintaining production goals and quality standards.
• Communicates with staff members, and other stakeholders involved in the audit process
• Works with providers, nurses, and other staff to identify areas of improvement in care delivery based on audit findings
• Provides support that ensures clinic policies, protocols, and procedures are being followed by staff members
• Tracks, trends, and reports staff responses and patient outcomes.
• Prepares and distributes reports summarizing findings from clinical audits, including recommendations for improvement
• May review insurance claims and appeals when requested to ensure they are accurate and processed correctly
• Complete multiple tasks and meet deadlines for assigned projects and reports.

Qualifications

• Active compact LPN license
• Excellent written and verbal skills are required as well as outstanding interpersonal skills
• Able to work in a fast-paced environment, demonstrate excellent problem solving, critical thinking, and organizational skills.
• Understanding of medical terminology required
• Knowledge of CPT, HCPCS, and ICD10 coding
• Must have exceptional attention to detail
• Must have access to high-speed internet
• Basic excel skills will be expanded to an intermediate level
• Self-motivated, self-directed, team oriented, and responsible, with a positive attitude and a proactive style. Possesses the ability to operate in a highly variable work environment.
• Presents a courteous and competent demeanor to our clients and teammates.

Physical Requirements

• Mobility and Lifting: Frequent sitting for extended periods of time; frequent standing; frequent lifting up to 25 pounds.
• Visual: Constant ability to read information, including close up; constant ability to use a computer screen; frequent use of good overall vision, including color perception.
• Dexterity: Constant eye and hand coordination and manual dexterity to write, operate a computer keyboard and finely manipulate small objects.
• Emotional/Psychological: Constant ability to make decisions and concentrate.
• Emotional/Psychological: Constant ability to make decisions and concentrate.

Qualifications

Qualifications

• Active compact LPN license
• Excellent written and verbal skills are required as well as outstanding interpersonal skills
• Able to work in a fast-paced environment, demonstrate excellent problem solving, critical thinking, and organizational skills.
• Understanding of medical terminology required
• Knowledge of CPT, HCPCS, and ICD10 coding
• Must have exceptional attention to detail
• Must have access to high-speed internet
• Basic excel skills will be expanded to an intermediate level
• Self-motivated, self-directed, team oriented, and responsible, with a positive attitude and a proactive style. Possesses the ability to operate in a highly variable work environment.
• Presents a courteous and competent demeanor to our clients and teammates.