ASC/Professional Surgical Coding Auditor & Educator (REMOTE)

Trinity Health • Livonia, MI

6d • Remote

About The Position

Uses specialized knowledge to support key areas of the organization related to an area of expertise. Uses data, research analysis, critical thinking & problem-solving skills to support colleagues & leadership in achieving organization’s strategic objectives. Serves as a peer influencer & may direct a project or project team by applying industry experience & specialized knowledge.

Our Trinity Health Culture: Knows, understands, incorporates & demonstrates our Trinity Health Mission, Values, Vision, Actions & Promise in behaviors, practices & decisions.

Work Focus: Researches, collects & analyzes information. Identifies opportunities, develops solutions, & leads through resolution. Collaborates on performance improvement activities as indicated by outcomes in program efficiency & patient experience. Responsible for distribution of analytical reports.

Process Focus: Utilizes multiple system applications to perform analysis, create reports & develop educational materials. 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.

Data Management & Analysis: Research & compiles information to support ad-hoc operational projects & initiatives. Synthesizes & analyzes data & provides detailed summaries including graphical data presentations illustrating trends & recommending practical options or solutions while considering the impact on business strategy & supporting leadership decision making. Leverages program & operational data & measurements to define & demonstrate progress, ROI & impacts.

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.

Requirements

• Associate degree in Health Information Management or a related field or an equivalent combination of years of education & experience.
• Must possess extensive knowledge of ICD-10, HCPCS, CPT, and HCC guidelines, medical terminology, regulatory guidelines including Medicare and Medicaid, and payer polices.
• Five (5) or more years of professional coding experience including surgical procedures and two (2) years of auditing and or education.
• Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Coding Specialist (CCS), or Coding Profession Certification (CPC) is required.

Nice To Haves

• Bachelor's degree in health information management (HIM) or related healthcare field is preferred
• Preferred prior experience in auditing and provider education.
• Preferred credentials: Certified Professional Medical Auditor (CPMA), Certified Risk Coder (CRC), Clinical Documentation Expert – Outpatient (CDEO).

Responsibilities

• Provides high level technical competency & subject matter expertise analyzing coding and documentation review for complex services, including code selection of surgical procedures & assessment of high-acuity type services.
• Conducts comprehensive audits of professional coders and providers to ensure accuracy, compliance, and alignment with CPT, ICD 10, HCPCS, HCC and payer specific-specific guidelines.
• Analyze documentation and coding patterns to identify risks related to compliance, revenue integrity, and regulatory requirements.
• Provides clear, actionable feedback to providers, coders, and leadership to improve documentation quality and coding accuracy.
• Develops and delivers targeted education and training programs based on audit findings, regulatory updates, and identified knowledge gaps.
• Provides training and onboarding to new audit and education of colleagues & providers.
• Adheres to coding quality & productivity standards as established by Revenue Excellence; Maintains accuracy of 95% or greater per coding audits; Responsible for completion of audit and education workplan as defined by the Service Area Manager of Coding Audit and Education.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree