Quality Reviewer
Radiation Oncology
Full Time
Day Shift
Between the hours 0700AM-500PM
Sign-On Bonus: 0
Lexington Health is a comprehensive network of care that includes six community medical and urgent care centers, nearly 80 physician practices, more than 9,000 health care professionals and Lexington Medical Center, a 607-bed teaching hospital in West Columbia, South Carolina. It was selected by Modern Healthcare as one of the Best Places to Work in Healthcare and was first in the state to achieve Magnet with Distinction status for excellence in nursing care. Consistently ranked as best in the Columbia Metro area by U.S. News & World Report, Lexington Health delivers more than 4,000 babies each year, performs more than 34,000 surgeries annually and is the region's third largest employer.
Lexington Health also includes an accredited Cancer Center of Excellence, the state’s first HeartCARE Center, the largest skilled nursing facility in the Carolinas, and an Alzheimer’s care center. Its postgraduate medical education programs include family medicine and transitional year residencies, as well as an informatics fellowship.
Job Summary
Reporting to the Director/Medical Director, the Quality Reviewer carries out audits for chart QA and charges on all Radiation Medicine patients. The reviewer ensures accounts are prepared for final billing in an accurate and timely manner with Corporate Compliance. The Reviewer manages and reports departmental data for statistical trending and evaluation of services and implements reports for specific Departmental needs. The Reviewer monitors and facilitates patient satisfaction, recommending enhanced services and improved processes. The Reviewer ensures Departmental compliance with HIPAA policies and regulations.
Minimum Qualifications
Minimum Education: Bachelor's Degree in Health Care or Management Field
Minimum Years of Experience: 5 Years previous experience as a Registered Therapist
Substitutable Education & Experience: None.
Required Certifications/Licensure: ARRT in Radiation Therapy;
Current SC License.
Required Training: Computer literate;
Knowledge of billing.
Essential Functions
- Quality Services/Patient Care/QI:
- Promotes a quality environment conducive to exceptional Radiation Oncology services.
- Monitors and assesses environment of care specific to patient satisfaction. Makes recommendations for enhanced services and processes.
- Works with the Director and staff to minimize or eliminate barriers to quality care.
- Audits and reviews Radiation Oncology charts on a weekly basis for accuracy and thoroughness in charting, documentation, and charging.
- Serves on the Department’s CQI Committee.
- Demonstrates competence to provide developmentally appropriate care/treatment for the following patient populations: Adolescent (13 years through 17 years), Adult (18 years to 65 years), Geriatric (Over 65 years).
- Material Resources:
- Makes recommendations to Management for tools and resources needed to enhance patient satisfaction and services.
Duties & Responsibilities
- Data Management/Reporting:
- Generates and Reports monthly and yearly statistical data for Accounting, LMC Administration, and DHEC.
- Tracks and trends statistical data for Director/internal Departmental review.
- Implements ARIA reports and custom EPIC reports for staff and physicians for the purpose of enhancing workflow and assessing volume and referral trends.
- Discharges all HRON accounts which are no longer active.
- Reviews all charts upon initiation and completion and properly ICD codes them for efficient and accurate final billing.
- Maintains up-to-date chargemaster, staying current with latest CPT rules and reimbursement issues.
- Performs all other duties as assigned.
We are committed to offering quality, cost-effective benefits choices for our employees and their families:
- Day ONE medical, dental and life insurance benefits
- Health care and dependent care flexible spending accounts (FSAs)
- Employees are eligible for enrollment into the 403(b) match plan day one. LHI matches dollar for dollar up to 6%.
- Employer paid life insurance – equal to 1x salary
- Employee may elect supplemental life insurance with low cost premiums up to 3x salary
- Adoption assistance
- LHI provides its full-time employees employer paid short-term disability and long-term disability coverage after 90 days of eligible employment
- Tuition reimbursement
- Student loan forgiveness
Equal Opportunity Employer
It is the policy of Lexington Health to provide equal opportunity of employment for all individuals, and to remain compliant with applicable state and federal laws and regulations. Lexington Health strives to provide a discrimination-free environment, and to recruit, select, on-board, and employ all employees without regard to race, color, religion, sex, age, disability, national origin, veteran status, or pregnancy, childbirth, or related medical conditions, including but not limited to, lactation. Lexington Health endeavors to upgrade and promote employees from within the hospital where possible and consistent with the employee’s desires and abilities and the hospital’s needs.
Nearest Major Market: Columbia
Nearest Secondary Market: South Carolina