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Role Description

Work Remote Position ($24.5303-$36.7954). Provides oversight & support of the workflow & functions in accordance with level of experience, education & standards. Assumes an expanded role & increased responsibility including delegating to others. Participates in the development of & the process improvement of policies & procedures. Works closely with leadership to maintain efficient & effective operations to ensure quality in daily operations.

• Coordinates operational, technical & / or clerical support services that enhance or improve coordination, preparation & flow of the department process & core work.
• Plans & organizes workflows & prioritizes customers’ needs.
• May lead a small team; serves as a mentor.
• Creates & maintains procedural standards & records as appropriate for role.
• Develops & maintains educational programs for the team members, including new employee orientation.
• Utilizes multiple system applications for data collection & management.
• Incorporates basic knowledge of Trinity Health policies, practices & processes to ensure quality, confidentiality & safety are prioritized.
• Demonstrates knowledge of departmental processes & procedures & ability to readily acquire new knowledge.
• Collaborates on performance improvement activities as indicated by outcomes in program efficiency & patient experience.
• Helps to identify opportunities, develop solutions & lead the team through resolution.
• Employs effective & respectful written, verbal & nonverbal communications.
• Develops an environment of mutual confidence & trust through collaborative relationships.
• Effectively communicates goals, standards, program expectations, service performance & how the work serves Trinity Health objectives.
• Proactively recognizes, addresses & / or escalates organizational, operational & / or team conflicts.
• Maintains a safe, functional & organized workspace environment.
• Stewards productive use of resources (e.g., people, financial, equipment, supplies, materials) to achieve assigned commitments, experiences & quality standards.
• Accountable for continuous role-based self-development & leadership growth.
• Supports the professional growth of team members.
• Maintains a working knowledge of applicable federal, state & local laws / regulations, Trinity Health Integrity & Compliance Program & Code of Conduct.

Qualifications

• Associate’s degree in healthcare, business administration, finance, accounting, or related field or equivalent experience considered in lieu of degree.
• Minimum three (3) years of relevant coding and charge control work experience in a hospital and/or Physician Practice environment.
• Experience in revenue cycle, billing, coding, and/or patient financial services.
• Demonstrated knowledge of clinical processes, charge master maintenance, clinical coding (CPT, ICD-10, revenue codes & modifiers), charging processes & audits, & clinical billing.
• Working knowledge of third-party payer rules & requirements, computer operations & electronic interfaces related to charge documentation, capture & billing.
• Knowledge of charge capture, reconciliation, error management operations & overall revenue cycle operations.

Requirements

• Responsible for ensuring accurate CPT/HCPCS documentation for the patient billing process.
• Educating colleagues and ancillary departments in accurately documenting services performed.
• Reviewing charts, including nursing notes, physician orders, progress notes, and surgical or specialty notes.
• Verifying charges captured on the correct patient, correct encounter, correct date of service, with any required modifiers.
• Reviewing documentation, abstracting data and ensuring charges/coding are in alignment within AMA and Medicare coding guidelines.
• Performing coding functions, including CPT, ICD-10 assignment, documentation review and claim denial review.
• Providing “at-elbow support” to ancillary departments.
• Performing charge entry, charge approvals, and/or quality charge reviews.
• Responsible for coding and/or validation of charges for more complex service lines.
• Educating clinical staff on need for accurate and complete documentation to ensure revenue optimization and integrity.

Benefits

• Rooted in our Mission and Core Values, we honor the dignity of every person.
• Recognize the unique perspectives, experiences, and talents each colleague brings.
• Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.