Supervisor of Medical Group Coding Audit & Provider Education (REMOTE)

Trinity Health•Livonia, MI

12d•Remote

About The Position

Purpose Frontline, department-based role that supervises daily functions of assigned area(s). Provides clear direction & manages / advances people, processes, structures & / or programs that support direct / indirect care. 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 manner. Self-monitors & initiates corrections & / 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) Oversees & provides guidance on coding & charge audits, which includes, but not limited to E & M, Surgical / Procedural, HCC & Diagnosis coding & clinical documentation for the assigned service area’s providers & coding teams. Provides emphasis on adherence to Centers for Medicare and Medicaid Services (CMS) & other insurance carrier standards, optimizing revenues & the avoidance of monetary settlements from third party audits. Oversees retrospective & prospective medical record documentation audits of all regional network providers & other employed hospital-based physicians & the initial & ongoing medical documentation, audits & coding educational programs to providers, management & revenue site operations staff. Assists with complex coding technical & business issues & aligns action plans with local & Trinity goals & objectives & identifies patterns & trends impacting coding & charge capture & coordinates educational materials & communications. Reviews & responds to various quality or compliance reports, including scheduling additional audit & education & follow-up as needed until resolution; Communicates professional coding process improvements as appropriate to Revenue Cycle Site Operations leadership.

Requirements

Associate’s degree in related field & professional coding or auditing experience or equivalent combination of education & professional coding or auditing experience.
Current standing as a Certified Professional Coder (CPC), Certified Risk Adjustment Coder (CRC), Registered Health Information Technician (RHIT), Certified Documentation Expert Outpatient (CDEO), or equivalent coding certification.
Valid driver’s license where required by assignment.

Nice To Haves

Previous supervisor or leadership experience (e.g., team leader, educator).
Experience in multi-specialty coding, with comprehensive knowledge of Medicare, Medicaid & other third-party billing rules & regulations.
Certified Professional Medical Auditor (CPMA) credential.

Responsibilities

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.
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.
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.
Performs work in an environmentally safe & professional manner.
Self-monitors & initiates corrections & / 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.
Oversees & provides guidance on coding & charge audits, which includes, but not limited to E & M, Surgical / Procedural, HCC & Diagnosis coding & clinical documentation for the assigned service area’s providers & coding teams.
Provides emphasis on adherence to Centers for Medicare and Medicaid Services (CMS) & other insurance carrier standards, optimizing revenues & the avoidance of monetary settlements from third party audits.
Oversees retrospective & prospective medical record documentation audits of all regional network providers & other employed hospital-based physicians & the initial & ongoing medical documentation, audits & coding educational programs to providers, management & revenue site operations staff.
Assists with complex coding technical & business issues & aligns action plans with local & Trinity goals & objectives & identifies patterns & trends impacting coding & charge capture & coordinates educational materials & communications.
Reviews & responds to various quality or compliance reports, including scheduling additional audit & education & follow-up as needed until resolution; Communicates professional coding process improvements as appropriate to Revenue Cycle Site Operations leadership.