Employment Type:
Full timeShift:
Day Shift
Description:
Purpose
Work Remote Position
Frontline, department-based; Supervises daily functions of assigned department; Provides clear direction & manages / advances people, processes, structures & / or programs that support direct / indirect care. The leader demonstrates behaviors in alignment with culture & creates / supports comprehensive strategies & measures progress to achieve desired outcomes.
Note: "patients" refers to patients, clients, residents, participants, customers, members
Essential Functions
Our Trinity Health Culture: Knows, understands, incorporates & demonstrates our Trinity Health Mission, Values, Vision, Actions & Promise in behaviors, practices & decisions.
Work Focus: Responsible for the daily operations & the oversight of staff. Supervisors work in collaboration with department managers to manage staff & department effectively. Participates in & contributes to the performance management / review process. Implements departmental plans & priorities identified by accountable leaders. May participate & recommend in the hiring & selection process. Responds promptly & directly to meet or exceed customers' needs.
Process Focus: Follows standards of performance & work processes in designated areas. Coordinates staff scheduling & assignment. Reviews & approves administrative functions (time, payroll, expense). Stewards productive use of resources (e.g., people, financial, equipment, supplies, materials) to achieve assigned commitments, experiences & quality standards.
Communication: 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.
Environment: Performs work in an environmentally safe, professional & healthy manner; self-monitors & initiates corrections and /or seeks guidance when needed. Demonstrates flexibility & self-direction by responding as a team player. Helps to create a positive work environment that promotes productivity. Accountable for continuous self-development & supporting the growth of others.
Maintains a Working Knowledge of applicable federal, state & local laws / regulations, Trinity Health Integrity & Compliance Program & Code of Conduct, as well as other policies, procedures & guidelines in order to ensure adherence in a manner that reflects honest, ethical & professional behavior & safe work practices.
Functional Role (not inclusive of titles or advancement career progression)
Provides day-to-day operational supervision for local hospital & / or Medical Group Provider Services (THMG) revenue integrity functions.
Prevents revenue leakage & maximizes potential revenue for the region through supervision of Charge Description Master (CDM), revenue integrity pre-bill edits, and root cause analysis, , including audits & & educating & training of multi-disciplinary hospital and/or THMG teams.
Works with Revenue Integrity leadership & Payer Strategies to ensure understanding of payer contracts, application of contract terms & ensures alignment with charging processes.
Monitors all Medicare & Medicaid websites, other payer websites & newsletters regarding medical policies & changes impacting charging, compliance, coding & billing. Supervises the process to apply updates & ensures compliance & revenue optimization.
Elicits feedback from interdisciplinary teams, including clinical colleagues & involves them in decision-making as appropriate. Ensure problem resolution & corrective action for long-term solutions, coordinating such efforts across the inter & intra-departmental channels.
Analyzes & displays data in meaningful formats; develops & communicates policies/procedures & other business documentation; manages & conducts special studies & prepares management reports, including Key Performance Indicators as they relate to the department.
(Pay Range: $31.8795-$47.8193)
Minimum Qualifications
High school diploma or equivalent.
Three (3) to Five (5) years of progressively responsible experience in revenue cycle operations or an equivalent combination of education & progressive revenue cycle experience, or revenue cycle consulting experience.
Comprehensive knowledge of Hospital &/or Physician Practice operations required.
Strong knowledge of Diagnosis Related Group (DRG), Ambulatory Payment Classification (APC) & Outpatient Prospective Payment System (OPPS) reimbursement structures & prebill edits including Outpatient Coding Edits (OCE) / Correct Coding Initiative (CCI) edits & Discharged Note Final Billed (DNFB)
Additional Qualifications (nice to have)
Associate degree preferred.
Supervisor or team leader experience preferred.
Licensure / Certification: RHIA, RHIT, CCS, CPC / COC, or other coding credentials strongly preferred. CDC (Healthcare Compliance Certification) & CHRI (Certificate in Healthcare Revenue Integrity) preferred.
Strong understanding of nationally & locally recognized charging practices, medical necessity & coding audits with ability to read medical charts & dictations & correlate services to charges on the claims forms (UB & 1500 forms).
Experience in Charge Description Master (CDM) maintenance is strongly preferred.
Physical & Mental Requirements & Working Conditions (General Summary)
Direct Healthcare Services / Indirect Healthcare / Support Services:
Exposure to conditions which may be considered unpleasant to sight, touch, sound & / or smell. Occasional
Exposure to fumes, odors, dusts,mists & gases, biohazards / hazards (mechanical, electrical, burns, chemicals, radiation, sharp objects, etc.). Occasional
Exposure to or subject to noise, infectious waste, diseases & conditions. Occasional
Exposure to interruptions, shifting priorities & stressful situations. Frequent
Ability to follow tasks through to completion, understand & relate to complex ideas / concepts, remember multiple tasks & regimens over long periods of time & work on concurrent tasks / projects. Continuous
Ability to read small print, hear sounds & voice / speech patterns, give / receive instructions & other verbal communications (in-person & / or over the phone / computer / device / equipment assigned) with some background noise. Continuous
Perform manual dexterity activities & / or grasping / handling. Frequent
Ability to climb, kneel, crouch & / or operate foot controls. Occasional
Use of computer / other technology. Continuous
Sit with the ability to vary / adjust physical position or activity. Continuous
Maintain a safe working environment & use available personal protective equipment (PPE). Frequent
Comply with Trinity Health's Code of Conduct, policies, procedures & guidelines. Continuous
Ability to provide assistance in the event of an emergency. Occasional
Direct Healthcare Services:
Perform activities that require standing / walking with the ability to vary / adjust physical position or activity. Occasional
Lift a maximum of 30 pounds unassisted. Occasional
Use upper & lower extremities, engage in bending / stooping / reaching & pushing / pulling. Occasional
Work indoors (subject to travel requirements) under temperature-controlled & well-lit conditions. Continuous
Encounter worksites (e.g., patient homes) or travel to worksites that may have variable internal & external environmental conditions. Occasional
Perform work that involves physical efforts (e.g., transporting, moving, positioning & / or ambulating patients). Occasional
Indirect Healthcare / Support Services:
Perform activities that require standing / walking with the ability to vary / adjust physical position or activity. Occasional
Lift a maximum of 30 pounds unassisted. Occasional
Experience of long periods of walking / standing / stooping / bending / pulling & / or pushing. Occasional
Encounter a clinical / patient facing / hands on interactive work environment. Frequent
Work indoors (subject to travel requirements) under temperature-controlled & well-lit conditions. Continuous
Work outdoors with variable external environmental conditions. Occasional
KEY: Average Workday Activity: Occasional (1% - 33%), Frequent (34% - 66%), Continuous (67% - 100%)
