Supervisor, Revenue Integrity (Remote)

Trinity Health•Livonia, MI

19h•$32 - $48•Remote

About The Position

This is a full-time, day shift position that is remote. The purpose of this role is to supervise the daily functions of the assigned department, provide clear direction, and manage people, processes, structures, and/or programs that support direct/indirect care. The leader will demonstrate behaviors aligned with the Trinity Health culture and create comprehensive strategies to achieve desired outcomes. The role focuses on daily operations and staff oversight, working collaboratively with department managers. Responsibilities include participating in performance management, implementing departmental plans, and potentially participating in hiring. The position requires responding promptly to customer needs, following performance standards, coordinating staff scheduling, reviewing administrative functions, and stewarding resources productively. Effective communication, creating a positive work environment, and maintaining a working knowledge of applicable laws and compliance programs are essential. The functional role involves providing day-to-day operational supervision for revenue integrity functions at local hospitals and/or Medical Group Provider Services (THMG). This includes preventing revenue leakage and maximizing potential revenue through supervision of the Charge Description Master (CDM), pre-bill edits, root cause analysis, audits, and educating multi-disciplinary teams. The role also involves working with Revenue Integrity leadership and Payer Strategies to ensure understanding of payer contracts and alignment with charging processes, monitoring payer websites for policy changes, applying updates for compliance and revenue optimization, eliciting feedback from interdisciplinary teams, ensuring problem resolution, analyzing data, developing policies/procedures, and preparing management reports including Key Performance Indicators.

Requirements

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)

Nice To Haves

Associate degree preferred
Supervisor or team leader experience preferred
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

Responsibilities

Supervises daily functions of assigned department
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
Responsible for the daily operations & the oversight of staff
Works 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 & 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
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