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

Roles & Responsibilities

  • Associate’s degree in related field
  • Professional coding or auditing experience or equivalent combination of education
  • Current standing as CPC, CRC, RHIT, CDEO, or equivalent coding certification
  • Valid driver's license if required by assignment

Requirements:

  • Oversees coding and charge audits for the assigned service area, including E/M, surgical/procedural, HCC, and documentation coding
  • Leads retrospective and prospective medical record documentation audits and develops coding educational programs for providers and management and revenue site operations staff
  • Ensures adherence to CMS and other payer standards to optimize revenues and reduce risk of third-party audit settlements
  • Reviews quality and compliance reports, communicates process improvements, and coordinates educational materials and actions with Revenue Cycle Site Operations leadership

Job description

Employment Type:

Full time

Shift:

Description:

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.
  • pay grade 13 range 75,592.7054-113,389.0581  Actual compensation will fall within the range but may vary based on factors such as experience, qualifications, education, location, licensure, certification requirements, and comparisons to colleagues in similar roles.

Minimum Qualifications

  • 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.

Additional Qualifications (nice to have)

  • 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.

Physical & Mental Requirements & Working Conditions (General Summary)

  • Direct Healthcare Services / Indirect Healthcare / Support Services:  
  • Exposure to conditions which may be considered unpleasant to sight, touch, sound & / or smell. Occasional 
  • Exposure to fumes, odors, dusts, mists & gases, biohazards / hazards (mechanical, electrical, burns, chemicals, radiation, sharp objects, etc.).    Occasional 
  • Exposure to or subject to noise, infectious waste, diseases & conditions.     Occasional 
  • Exposure to interruptions, shifting priorities & stressful situations.      Frequent 
  • Ability to follow tasks through to completion, understand & relate to complex ideas / concepts, remember multiple tasks & regimens over long periods of time & work on concurrent tasks / projects.     Continuous 
  • Ability to read small print, hear sounds & voice / speech patterns, give / receive instructions & other verbal communications (in-person & / or over the phone / computer / device / equipment assigned) with some background noise.    Frequent 
  • Perform manual dexterity activities & / or grasping / handling.    Continuous 
  • Ability to climb, kneel, crouch & / or operate foot controls.     Occasional
  • Use a computer / other technology.     Continuous 
  • Sit with the ability to vary / adjust physical position or activity.     Continuous 
  • Maintain a safe working environment & use available personal protective equipment (PPE).     Continuous 
  • Comply with applicable Code of Conduct, policies, procedures & guidelines.     Continuous 
  • Ability to provide assistance in the event of an emergency. Occasional

Indirect Healthcare / Support Services:

  • Perform activities that require standing / walking with the ability to vary / adjust physical position or activity.     Occasional
  • Lift a maximum of 30 pounds unassisted.     Occasional 
  • Experience of long periods of walking / standing / stooping / bending / pulling & / or pushing.   Occasional
  • Encounter a clinical / patient facing / hands on interactive work environment.     Occasional 
  • Work indoors (subject to travel requirements) under temperature-controlled & well-lit conditions.     Continuous 
  • Work outdoors with variable external environmental conditions.     Occasional

Average Workday Activity: Occasional - O (1% - 33%), Frequent - F (34% - 66%), Continuous - C (67% - 100%) 

Our Commitment

Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.

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