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Bariatric Clinical Reviewer (Full-Time)

  • BELLEVILLE, NJ
  • Clara Maass Medical Center
  • Bariatric Program
  • Day
  • CLERICAL / ADMINISTRATIVE SUPPORT
  • Posted: April 8, 2021
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Summary

Located in Belleville, Clara Maass Medical Center is a facility of RWJBarnabas Health and provides a complete continuum of care to residents of northern New Jersey. With over 700 physicians and 2,100 employees, we offer advanced treatment for a wide variety of medical conditions. Our facility includes centers for advanced wound care, sleep disorders, bariatrics, orthopedics cardiac services, cancer care, emergency services, and more. In 2017,  the Medical Center completed a state-of-the-art campus expansion featuring a new four-story 87,000 square foot building with a private, 32-bed Intensive Care Unit, new Main Entrance and Lobby, Retail Pharmacy, Patient Registration Area and designated space to our recently expanded  Emergency Department.

Clara Maass Medical Center has been recognized nationally for its quality and patient safety by Healthgrades and by the Leapfrog Group, having earned its twelfth Grade A in 2019. The Medical Center has received Disease Specific Care Certification from the Joint Commission for Acute Coronary Syndrome (ACS), Congestive Heart Failure, Hip Replacement, Knee Replacement, Cardiac Rehabilitation and Advanced Certification in Palliative Care and is listed by the American Hospital Association as one of Healthcare’s Most Wired hospitals. In 2018, the Medical Center earned designation in LGBTQ Healthcare Equality from the Human Rights Campaign Foundation.

We are currently looking for a Full-Time Bariatric Clinical Reviewer (MBSCR) to perform timely and accurate data entry into the Data Registry Platform, by fulfilling 100 percent of metabolic and bariatric case abstraction duties. CMMC and its medical staff commit to provide structure, process and personnel to obtain and maintain the quality standards of the MBSAQIP in caring for metabolic and bariatric patients. 

Responsibilities: 

  • Collection of preoperative, intraoperative, 30 day postoperative and long-term (6 month and annual thereafter) follow-up on a compounding number of patients over time, and fulfill requests for patient data and reports.  
  • Maintain access to appropriate resources, including data and information systems, to ensure that appropriate short-term and long-term data points are available in the medical records.
  • Work closely with various departments to identify opportunities for clinical quality improvement and other special projects that may be identified by analysis metrics to support process improvement activities.  
  • Collaborate with the MBS Director and NJBMI’s team to report and discuss cases, including volume, re-operations, readmissions, transfers, mortalities, and Semi Annual Reports.
  • Attend MBS Committee meetings, participate in teleconferences with MBSAQIP, and periodically attend in-person/virtual professional development seminars offered at various annual meetings such as ASMBS, ACS NSQIP, or ACS Clinical Congress.
  • Review current literature for evidenced-based clinical practice guidelines related to care of the Bariatric patient.
  • Ensure clinical policies/procedures governing the program, and standing orders related to the care of the patients reflect the most current evidence-based medicine guidelines.
  • Ensure collaboration with the reporting of the Program’s Quality and Performance Improvement measure results to the Performance Improvement Committee, Hospital Performance Improvement Council, and Medical Executive Committee.
  • Maintain the established open and unrestricted access to electronic and paper medical records for all patient-related data from the center and physicians’ offices.
  • Participate in ongoing training and support recertification requirements, including the MBSCR Online Training Program.
  • Revenue Cycle of Bariatric Department
    • Review workflow of all Medicaid inpatient (surgery) and outpatient (clinic) visits via Medaptus. Ensure all charges have been successfully captured and exported into Cerner CPM for full reimbursement.
    • Manage and clear up back charges in Cerner CPM work queue for uncredited Medicaid surgeries and clinic visits. Provide necessary documentation for all uncredited charges. (Providing authorizations, referrals, patient information if necessary and medical notes via SFTP (safe secure transfer portal).
  • Medicaid Clinic Assistance
    • Review all pre-surgery test requirements with Medicaid patients after initial visit in clinic. Set nutrition appointments for these patients, according to their insurance.

Qualifications:

  • Must possess appropriate clinical knowledge and expertise to collect the required data, computer knowledge, hospital systems knowledge, and hospital department knowledge.
  • Knowledge of the following platforms and resources used to retrieve data for MBSAQIPdata entry timeframes is preferred:
    • Cerner
    • 3M Medical Records
    • Baritrax 360 Patient Navigator
    • New York Baritrax 360 Patient Navigator  
  • Astute at interpreting and coordinating department financial reports. 

Reports to:  Manager, Bariatric Service Line

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