Risk/Quality Analyst - Surgery - Full Time
1. Directs daily operations of the non-clinical activities of the OR and OPSC.2. Participates in writing, reviewing and revising policies and procedures related to perioperative business activities.3. Develops and monitors systems for managing and tracking patient information, documents and forms required for clinical care and for billing of patient information, documents and forms required for clinical care and for billing of patients.4. Monitors and analyzes data and information to measure utilization, growth, productivity and profitability.5. Oversees the development of the monthly/annual case/visit statistic and ad hoc reports.6. Directs the patient billing process to insure accurate and timely billing process.7. Develops systems for periodic audits of patient billings to assess accuracy of billing and reimbursement.8. Oversees chargemaster; reviews and upgrades on a regular basis.9. Manages the case scheduling process.10. Participates in hospital and department meetings as requested.11. Collaborates with Purchasing, Materials Management and Biomedical Engineering Department regarding the acquisition, maintenance, repair and tracking of equipment, instruments and supplies.12. Assist the Director in the maintenance of accurate, current equipment inventory in collaboration with material management.13. Maintains accurate, current tracking system for biomedical equipment in collaboration with biomedical engineering department.14. Educates, assists and supports clinical leadership team in budget preparation, monitoring, management and control.15. Recommends strategies to maintain budget compliance.16. Assists Perioperative Leadership team planning, preparation and justification for annual capital budget request.17. Assists in the development of tracking systems for acquisitions of capital equipment.18. Establishes and maintains policies for authorization and approval of purchases, charging cost centers as appropriate.19. Generates timely department financial reports.20. Consistently expands business knowledge to provide the most current information on practices and strategies that will most likely increase revenue for the department.21. Assists in developing and implementing marketing tactics at the direction of the Director, Perioperative Services and the Director, Surgery.22. Maintains current and future statistical database regarding clinical program development.23. Identifies opportunities to increase revenue through correct coding, documentation and compliance.24. Selects, hires, orients, supervises and evaluates business and administrative staff.25. Provides ongoing education and training for business staff.26. Manages payroll compliance in accordance with hospital policies.27. Develops and oversees position control system for perioperative units.28. Demonstrates behavior consistent with hospital mission, values, polices and procedures.Consistently demonstrates professional behavior. Responsible for generating productivity reports for Same Day Surgery, G.I. Laboratory and PACU.Operating Room - totals minutes on Anesthetist and surgery times, balance schedules and totals in/out patients. Fax’s and/or emails statistics to appropriate departments, and designated Managers. Collects invoices from Operating Room: Generate invoices; Retrieves invoices; Compares with patient implant sheets; Generates temporary purchase order number through Quick Books; Scans to VI Web; Maintains log books; Follows up with Materials Management on orders; Updates Quick Books as needed; Contacts Vendors with purchase order or email;. Batches Operating Room charges: Compares charges with invoices; Looks up IMMS for pricing; Looks up FVRH CDM for code. If not available, goes to Standard. Ensures request has been reviewed prior requesting CDM; Ensures approved CDM’s are added to list and emailed to designated departments; Posts charges on P-BAR; Late charges added to the H:Drive; Follows up on A-8 on a daily basis. Brings errors to the attention of the appropriate staff member; Completed A-8 are signed, dated and forwarded to the Director of Surgery; Performs follow-up on A-140 to ensure charges are posted the day before submission; Follows up with the I.S. Department on computer-related issues; Reviews nursing records for errors. Found errors are brought to the attention of the appropriate staff member for correction. Chart Audit - Attends monthly meetings; runs late batch report; pulls requested charts for reviews. Pulls charts for the Finance Department for review upon request. Picks up nursing records, patient charts for batching, invoices and departmental mail. C2Q - collects data from operating room cases, enters information on the C2Q log, completes daily balance score card with C2Q information and surgery schedule, emails end of the month reports to designated individual.End-Of-Month Reports: Run’s physician reports; Infection Control Reports; Block Time reports that include statistics for each physician’s block time and completes graph.
A. Minimum Education: High school graduate or equivalent.B. Minimum Experience: Prefer 1-2 years experience in an acute care environment, preferably in a surgical setting.C. Preferred Skills and Abilities: Skills in healthcare related billing experience preferred. Must be computer literate, organized, and proven attention to detail. Analytic/statistical, background knowledge preferred. Job: Surgical ServicesPrimary Location: Fountain Valley, CaliforniaHospital Location: Fountain Valley Regional Hospital and Medical CenterJob Type: Full-timeShift Type: Days Employment practices will not be influenced or affected by an applicant’s or employee’s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status.
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