Medical Auditor/RN- Senior

The compensation range listed reflects the range Northern Light Health anticipates relying on in setting the wages for the position. The range may not necessarily include all additional compensation elements available, such as differentials, incentive programs and benefits. Northern Light Health Department: Internal Audit Position is located: Cianchette Professional Blding Work Type: Full Time Hours Per Week: 40.

00 Work Schedule: No Hours Assigned Salary Range : $ 35.92 - $55.13 Exempt: Yes Summary : Under the direction of the Director of Internal Audit, this position will plan and conduct audits of Northern Light Health and any of its members with a focus on clinical activities (e.g., coding, billing, safety, etc.), the safeguarding of assets, accuracy and reliability of data, and compliance with policies, procedures, and regulatory requirements to protect Northern Light Health from loss through error, fraud, or operational inefficiencies.

Audit activities will include the planning, preparation, delivery, reporting and evaluation of engagement activities and results in response to the needs of internal stakeholders and/or external parties (e.g., external auditors, regulatory agencies, etc.) In carrying out these activities, the Senior Medical Auditor shall have full, free and unrestricted access to all functions, records, property, and personnel.

The Senior Medical Auditor will serve as a mentor to junior Internal Audit staff. The Senior Medical Auditor must be strong in analytics and have well-developed written and oral communication skills. The Senior Medical Auditor must possess personal computer proficiency, a commitment to high-quality customer service and the ability to manage multiple projects and priorities.

The Senior Medical Auditor must have a high degree of honesty and professionalism and possess interpersonal skills necessary to develop and foster relationships with various levels of clinical staff and management at the various Northern Light Health members. The Senior Medical Auditor also will function as a clinical expert to the Northern Light Health Compliance and Internal Audit teams.

Responsibilities

Plan, execute, lead, and conduct audits. Mentor junior Internal Audit staff. Provide clinical audit and assurance services, assistance and guidance to Northern Light Health and its Member Organizations. Prepare formal written reports ensuring audit objectives are met, conclusions are documented and supported, and recommendations are clear and concise.

Make oral and written presentations to management during and at the conclusion individual audits, discussing deficiencies, recommending corrective action, and suggesting improvements in operations. Perform follow-up procedures to determine whether recommendations have been implemented. Other duties. Other Information : Required Knowledge, Skills, and Abilities: Ability to work independently, prioritize tasks, and handle deadlines and multiple projects.

Excellent written and oral communication skills. Excellent analytical skills. Creativity and resourcefulness in finding solutions to problems. Critical thinking and organizational skills. Understanding of medical office processes and procedures. Thorough knowledge of CPT and ICD-9 coding. Competencies and Skills Coding and reimbursement software for Health Information Systems.

Achieves Results: Sets high standards for their own outcomes and seizes opportunities to engage others towards objectives. Consistently moves forward with direct actions in order to attain or exceed objectives. Manages their own time effectively to accomplish assigned tasks. Successfully prioritizes multiple projects and duties as needed.

Applies Business Acumen:Demonstrates knowledge of current and future trends that impact organizational success. Applies proven practices and business theories to get results that meet financial as well as other business goals. Recognizes opportunities for new services and products and acts accordingly, taking measured risks into consideration.

Possesses a thorough knowledge of their field and independently carries out their work in accordance with professional standards of the profession. Electronic medical record software. Demonstrates Adaptability: Learns quickly when facing a new problem or unfamiliar task; is flexible in their approach with changing priorities and ambiguity.

Manages change effectively and does not give up during adversity. Capable of changing one's behavioral style and/or views in order to attain a goal. Absorbs new information readily and puts it into practice effectively. Demonstrates Emotional Intelligence: Exhibits a high level of self-awareness, self-management, other awareness and relationship management.

Conducts themselves in an empathic, appropriate way, with a sense of humor and stimulates a collaborative work environment. Is respectful of the attitudes, feelings, or circumstances of others and aware of the influence of their own behavior on them. Is aware of relevant social, political, system, and professional trends and developments and uses this information for the organization's benefit.

Develops Self and Others:Takes responsibility for engaging in professional self-development activities and programs. Strives to gain insight into their own values, strengths and weaknesses, interests and ambitions and takes action in order to enhance competencies and skills when possible. As a leader, encourages and guides employees towards growth opportunities to enhance performance and help them reach goals.

Reviews and analyzes employees' strengths and weaknesses to distinguish their talents and development needs, and to ensure they are enhanced appropriately. Effectively Communicates: Listens, speaks and writes appropriately, using clear language. Communication methods are fitting to the message(s), audience, and situation and follow-ups are regular and timely.

Shows that important (non-) verbal information is absorbed and understood and asks further questions to clarify when necessary. Expresses ideas and views clearly to others and has ability to adjust use of language to the audiences' level. Exercises Sound Judgment & Decision Making: Understands and processes complex information, which allows for appropriate and accountable conclusions.

Does not react too quickly or slowly. Balances facts, goals, and potential approaches taking the appropriate criteria into account. Makes active decisions and commits oneself by communicating confidently and respectfully. Fosters Innovation: Employs and encourages the use of meaningful creativity in solving challenges.

Proactively identifies opportunities and uses new approaches to enhance processes, systems and services. When appropriate, suggests or initiates new strategies, products, services, and markets. Influences and Inspires: Builds enthusiasm and commitment among others to move in a desired direction and models it personally.

Creates a compelling vision of success that motivates workplace initiative and energizes others to follow. Provides direction and guidance to encourage cooperation between team members in order to attain an objective. Has the ability to appropriately influence others' actions and decisions with and without express authority.

Ability to understand the language used to precisely describe the human body including its components, processes, conditions affecting it, and procedures performed upon it. Spreadsheet application with the ability to use calculations, formulas, graphing tools, pivot tables, and a macro programming. Word processing, spreadsheets, data entry, database experience and other computer related skills.

Email application with the ability to manage email as well as calendars, managing tasks and contacts, note taking, journaling, and web browsing. MS Teams Word process application with the ability to create and edit documents, format, use tables, apply footnoting, create table of contents and mail merge techniques. Public Speaking Seeks Process Improvement & Applies System Thinking: Possesses and gains insight into situations, problems and processes.

Understands the interconnection between organizational elements. Deconstructs problems and systematically investigates the various components. Considers the impact of actions on the entire process/system. Detects problems and opportunities, recognizes important information, and links various data to trace potential causes and relevant details.

Siemens Clinical software. Business intelligence and data analysis software. Utilizes Resources Effectively: Understands how to get the most out of available resources and uses cost-benefit thinking in decision-making and in setting priorities. Monitors and analyzes resource usage to identify and eliminate areas of waste and maximize resources.

As a leader, defines targets and provides appropriate means; oversees progress and makes adjustments when necessary. Appropriately delegates work, sets clear direction and manages workflow and time. Zoom Behaves with Integrity and Builds Trust: Acts consistently in line with the core values, commitments and rules of conduct.

Leads by example and tells the truth. Does what they say they will, when and how they say they will, or communicates an alternate plan. Cultivates Respect: Treats others fairly, embraces and values differences, and contributes to a culture of belonging, empowerment, and cooperation. Fosters Accountability: Creates and participates in a work environment where people hold themselves and others accountable for processes, results and behaviors.

Takes appropriate ownership not only of successes but also mistakes and works to correct them in a timely manner. Demonstrates understanding that we all work as a team and the quality and timeliness of work impacts everyone involved. Practices Compassion: Exhibits genuine care for people and is available and ready to help; displays a deep awareness of and strong willingness to relieve the suffering of others.

Credentials Required Registered Nurse Education Required Master's Degree Required Experience 8 year/years of Relevant Work Experience Working Conditions Need to travel to perform responsible duties Work with computers, typing, reading or writing. Prolonged periods of sitting. Lifting, moving and loading less than 20 pounds.

As an integrated health delivery system serving Maine, Northern Light Health is raising the bar with no-nonsense solutions that are leading the way to a healthier future for our state. Our care team—in hospitals, primary and specialty care practices, long-term and home healthcare, behavioral healthcare, and ground and air medical transport and emergency care—are committed to making healthcare work for you: our patients, communities, and employees.

Questions? Contact Talent Acquisition: phone: 207-973-7100 email: [email protected] Brewer, Maine, Corporate Office, Cianchette, Foundation, Finance, Human Resources, Legal Services