Employment Type: Full time
Shift:
Description: Purpose
- 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.
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
- 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.
Functional Role (not inclusive of titles or advancement career progression)
- 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.
Minimum Qualifications
- Associate degree in Health Information Management or a related field or an equivalent combination of