- Audit medical record both open and closed for appropriateness and completeness from the sample size approved by the hospital.
- Prepare audit findings analysis report and provide recommendations on improving documentation.
- Checkallpatientrecorditementriesin the patient record against the auditing tool.
- Co-ordinate clinical audit activity for all clinical divisions.
- Provide advice and guidance on the completion of all clinical audit projects.
- To ensure clinical audit projects have a SMART action plan in place (where appropriate).
- Maintain an actions tracker identifying outstanding actions and ensuring evidence is provided for all completed actions.
- To ensure non-compliance is escalated to the Clinical Heads, COS, Head Nurses and the Chief of Quality for entry onto the risk register where required and for reporting to relevant committees- QI committee, Medical Staff Executive Committee, or Hospital Executive Committee.
- Contact the concerned person for completion of his/her delinquent entries.
- Participates in and/or leads inter-departmental process improvement initiatives.
- Actively participate in identifying financial issues while conducting clinical audit of medical records.
- Identifies incomplete documentation that could affect a healthcare facility's livelihood by examining the coding procedures and ensuring the organization complies with regulatory requirements.
- Aggregate the results of the audit and submit a periodic report of the deficiencies to the concern department
- Expected to identify fraudulent claims, outliers, reimbursement deficiencies, inefficiencies, incorrect codes and poor documentation to improvement the organization being challenged by the government or insurance companies.
- Performs patient inquiry audits as requested.
- Provide support to all key quality improvement and patient safety initiatives and work programs.
- Provide education to other healthcare professionals regarding correct documentation and detailed recommendations to improve the organizations procedures and policies.
- Maintainconfidentialityduringtheauditingprocess.
- AuditpatientfilepresentedforreviewbyMortality and Review committee.
- Leads the Auditing team for the open and closed medical record auditReview.
- Identify variances in the delivery of patient centered care through the Medical informatics auditing process and initiate OVR's for further investigation.
- Participatesinthereviewofallmedicalrecords templates hospital wide.
- Performsotherdutiesrelatedtohis/her position as needed.
- Providepersonalizedcoordinatedcare,andsupportforpatients and families.
- Treatpeoplewithdignity,compassion and respect.
- Graduate of a recognized, accredited school of Medicine/ Nursing/ Allied Health with current registration in country of origin and a license to work in Saudi Arabia.
- Certified Clinical Documentation Improvement (CDI)
- Minimumof3yearsworkingexperienceinhealthcare setting specially in auditing medical record.
- GoodcommandofEnglishandComputer skills.
- Excellent communication skills.
- Thorough knowledge, skills and techniques of good patient care.
- Knowledge of Medical record contents and terminology.
- Conflict Resolution.
- Analytical skills
- Facilitation in Problem Solving.
- People management and problem solving skills.
- Positiveattitudeandabilitytowork under pressure and time constraints.
- Proper, effective and compassionate communication.
- Flexibility to perform a job.
- Honesty and consistency.
Clinical Auditor - Eastern Province, المملكة العربية السعودية - Almoosa Specialist Hospital
Almoosa Specialist Hospital
Eastern Province, المملكة العربية السعودية
تم العثور عليها في: Talent SA C2 - منذ 5 أيام