Knoxville Hospital And Clinics Work Values

Daily Duties at Knoxville Hospital And Clinics:

performed pre-certification, concurrent and retrospective chart review for medical necessity, appropriate level of care, Inpatient, Observation Status or Skilled Care-Swing Bed, and physician and staff documentation compliance in adherence to CMS, State, and Third Party Payer rules and regulations. Performed front end of discharge planning and was the co-chair of the Interdisciplinary Committee overseeing continuity of care of Inpatients, Observation Status and Skilled Care Swing Bed patients. Established a working DRG Assignment for patients on admission. Performed Review and Placed Psychiatric patients from the Emergency Room and Physicians Clinic (clinic is attached to hospital), when needed. Served on the Performance Improvement, Risk Management and Utilization Management Committee. Continually updated personal knowledge of CMS Medicare and Medicaid, State, and Third Party Payer rules and regulations providing updates and education to hospital Administration, Physicians and Staff. Provided one-on-one physician education, compliance training, once trending showed specific need for individual quality improvement. Was Instrumental in the initiation of the CMS National Quality Initiatives for the facility. Performed chart data abstraction for the Acute MI, CHF, and Surgery quality indicators, and submitted data to the QIO and Clinical Warehouse for compliance. Performed Outcome Reporting, Trending, and ongoing Physician, Nursing Staff, Pharmacy, Surgery Department, Lab and Emergency Department Education, Assisted Risk Management Coordinator with data and reports, Assisted the HIM, Health Information Management Department with Physician Compliance regarding documentation specifics as well as for quality, Was an Electronic Medical Record Champion when facility transferred from paper to electronic medical records. Performed some ICD-9, CPT and HCPCS Coding when needed in alliance with hospital coders. Was part of the HIPAA Compliance team, and the JCAHO Compliance team. As a Department Manager, attended multiple Leadership Management meetings and educational seminars to hone skills, Assisted in Marketing activities and Spoke at community functions and organizational events on behalf of the hospital regarding CMS updates for Seniors. Worked with the IFMC-QIO on a regular basis and have vast experience in working with Denials, Appeals and Outcome Mediation.

What they like about Knoxville Hospital And Clinics:

Organizations with strong, centralized leadership are particularly attractive to you. You require a work environment with leadership that aggressively seeks to expand and grow the business and does so in a visible and decisive manner. In general you prefer to work in an environment in which there is a strong link between leadership, its actions, and a strong set of company-wide values.

Tags

utilization review, clinical auditing, national quality initiatives, fraud and abuse investigation, Microsoft Word, Excel, Outlook, Access, physician education, oversight reporting, trending, profiling

Skills

Microsoft Word, Excel, Outlook, Access, Crystal Reporting

These are some of the questions we asked our climbers about their experiences with Knoxville Hospital And Clinics: