| Employer: | Trinity Health |
| Job Location: |
Farmington Hills - Oakland County |
| Employment Type: | Full Time |
| Salary Range: | $73,807 - $92,285 |
Description: |
The apply button posted on this website does not connect to Trinity Health application system.
Contact:
FOR MORE INFORMATION ON TRINITY HEALTH, AND TO APPLY ONLINE, GO TO http://www.trinity-health.org/Careers
POSITION PURPOSE
Provides management of operations of a central Contingent Coding and Defense Audit for Recovery Audit Contractors and other payers for all Trinity health Ministry Organizations, protecting > $30 Million in net revenue annually. . Monitors denials and identifies: 1) process improvements that need to be made with case management, patient admission designation/medical advisors, clinical documentation improvement, coding, patient access, and patient financial services to avoid future denials; 2) strategies and tactics to win appeals; 3) documentation and coding education to prevent future denials; 4) information system requirements supporting the defense audit process; and 4) trends in data showing educational and process improvement opportunities. Manages communication with the audit contractors. . Reports financial status of defense audit activity and works with reimbursement to identify future financial exposure given industry regulations and changes. Identifies leading practices for defense audit and technologies supporting defense audit processes. Manages UEM vendor relationships for defense audit processes. Provides coding, documentation, and compliance consultation and education support to Ministry Organizations. |
Qualifications: |
MINIMUM QUALIFICATIONS
Must possess a comprehensive knowledge in two or more functional areas of coding, documentation improvement, UR/Case Management, billing, or other revenue management functions. In addition, candidates with broad-based knowledge of health care finance and hospital operations are preferred. Experience gained through work at consulting organizations or project work supporting customers and management level experience in one or more revenue management functions required. Bachelor’s degree in Health Information Management (HIM), Business Administration or related field or an equivalent combination of education and experience and ten (10) years experience serving in a health care organization. Must have an in-depth knowledge of health care audit experience. Must be either a Registered Health Information Administrator (RHIA),Registered Health Information Technologist (RHIT), or Certified Coding Specialist. Must have ten (10) ten years of progressive experience in two or more related hospital functions, such as coding, billing and reimbursement, ten (10) of which should be in a lead and supervisory role. Must possess demonstrated knowledge of process improvement techniques and their application. Must possess ability to lead implementation and process improvement projects with minimal supervision. Must possess strong knowledge and practice of specific laws and regulations related to coding, billing and reimbursement imposed on health care systems by various agencies. Must have knowledge of coding guidelines. Must be able to demonstrate an advanced knowledge of both ICD-9-CM and CPT-4 coding procedures. Must have a proficient knowledge of Medicare, Medicaid and other third party payer documentation, coding and billing regulations. Working knowledge of Medicare Conditions of Participation required. Must possess excellent organizational and planning skills, including the ability to prioritize functions and monitor productivity. Must possess strong written and verbal communication skills in order to communicate in clear, concise terms to management at all levels, including the ability to articulate complex regulatory information in layman’s terms. Must possess computer skills, especially with Microsoft Word, Access and excel applications. Must be able to use Internet and other resource applications for research purposes and provide documentations that supports regulations quoted in audits. Demonstrated strong analytical and conceptual skills. Demonstrates strong written and verbal communication skills. Demonstrates strong management and leadership skills. Must possess a personal presence that is characterized by a sense of honesty, integrity and caring with the ability to inspire and motivate others to promote the philosophy, mission, vision, goals and values of Trinity Health. |
