Title:  Quality Review RN / Home Health Job

Summary

The Quality Review RN participates in the review and evaluation of documentation contained within or pertinent to patient records.  The incumbent ensures completion and accuracy in order to substantiate provision of patient care that is within the guidelines of reimbursement sources, state and federal regulations, and accrediting body standards. Records required information in the patient record prior to billing.  Collects data from patient records for quality analysis. Identifies gaps in documentation and collaborates with educators to develop and implement associate training.  Serves as a resource and signs off on Quality Review LPN charts. Participates in quality and process improvement projects as directed by the Quality Manager.  Models appropriate behavior as exemplified in MLH Mission, Vision and Values.

Education/Experience/Licensure

Knowledge/Skills/Abilities

• Excellent written and verbal communication skills.
• Ability to plan and schedule tasks and to maintain control of own workflow.
• General PC skills.
• Effective interpersonal relationship skills.

Key Job Responsibilities

• Reviews patient records to ensure provision of complete, accurate and timely documentation that meets federal, state and accreditation laws, guidelines and standards.
• Ensures documentation in patient records are within guidelines of reimbursement sources prior to billing.
• Identifies gaps in documentation and collaborates with educators to develop and implement associate training.
• Collects and trends data relative to medical record documentation and reports identified trends to supervisor.
• Participates in quality and process improvement projects.
• Performs other duties as assigned or required.

Physical Requirements

• The physical activities of this position may include climbing, pushing, standing, hearing, walking, reaching, grasping, kneeling, stooping, and repetitive motion.
• Must have good balance and coordination.
• The physical requirements of this position are: light work - exerting up to 25 lbs. of force occasionally and/or up to 10 lbs. of force frequently.
• The Associate is required to have close visual acuity to perform an activity, such as preparing and analyzing data and figures; transcribing; viewing a computer terminal; or extensive reading.
• The conditions to which the Associate will be subject in this position: The Associate is not substantially exposed to adverse environmental conditions; job functions are typically performed under conditions such as those found in general office or administrative work.