Medical Records Auditor CMA

CHI Memorial Medical Group (Mountain Management Services), a member of CommonSpirit Health, is a leading provider of comprehensive office management services for Memorial Health Partners and affiliated physicians in Southeast Tennessee and North Georgia. Our award-winning, faith-based organization is dedicated to supporting the delivery of exceptional healthcare in the region. We are proud to be consistently recognized for excellence by organizations like U.S. News & World Report, PINC AI™, CMS, Healthgrades®, Leapfrog, and as one of the Best Places to Work in Tennessee. We are honored to be your trusted ally in health, dedicated to serving our community with compassion and excellence.

Responsible for auditing medical records for all family and internal medicine practices in order to ensure gaps are closed for quality requirements specific for Medicare and mental health requirements for CHI/CSH employees. If programs expands for other payers this too will be grafted into the auditing requirements. This data and meeting metrics expected by payer(s) is also a requirement for membership in the CSH CIN network. Competent in understanding what medical data they are responsible for auditing in order for the patients and MD visits to qualify for what is needed for the program(s). Strong auditing and communication skills with stakeholders, providers and practice leaders.

• Travel to each practice to pull and review each required patient medical record. (Practices on paper require onsite visitation to pull charts and review.)
• Audit the requirements by payer for quality purposes, including but not limited to the following:
  
  a. Diabetes
  b. Hypertension
  c. Breast cancer screening
  d. Depression
  e. Colorectal screening
  f. Other as added by payers

• Enter data into the quality system used by Common Spirit Health/Clinically Integrated Network (CIN), which is currently Health Endeavours, in order to track and send data to payers for reporting, in order to qualify for the program by payers and CIN requirements.
• Meet with practice managers and providers to discuss gaps, needs, analysis and improvements, in order to stay compliant with program (s).
• Put together data and summarize information to communicate effectively with practices and providers.
• Run reports and use data systems, including, but not limited to Excel.

Required

• Certificate Other Medical Assistant and 1-3 years Medical Records and/or auditing medical records and/or HIM, upon hire
• Certified Medical Assistant AAMA, upon hire or
• Certified Medical Assistant AMCA, upon hire or
• National Certified Medical Assistant NCCT, upon hire or
• National Registered/Certified Medical Assistant NAHP, upon hire