Employment Type:

Full time

Shift:

Day Shift

Description:

Provides leadership and strategic oversight to the Holy Cross Medical Group's Professional Coding Team. Partners with Auditing, Revenue Integrity, Billing, Finance, and Operations to promote coding accuracy and adherence to local ministry and regional Trinity Health practices and policies. The Manager designs and builds structure, ensures standardized workflows, and provides guidance to the coding team.

Responsible for overseeing professional coding operations for the Holy Cross Medical Group (HCMG) ensuring accuracy, compliance, and timely charge capture and coding. This role leads a team of coders and drives standardization of coding workflows across specialties.

Knows, understands, incorporates, and demonstrates the Trinity Health Mission, Vision, and Values in behaviors, practices, and decisions.

Works with providers and ambulatory practice leaders to develop accurate, effective, efficient, and compliant charge capture and coding processes that ensure revenue is recorded for all services provided and clinical documentation exists to support all charges and coding assigned.

Ensures systems and processes comply with federal, state and payer-specific coding, billing and reimbursement guidelines.

Optimizes staff and overall revenue performance through process redesign, policy/procedure implementation, communications, continuing education and professional development activities, staff empowerment and feedback.

Establishes and monitors key performance measures and targets to achieve optimal performance.

Maintains a working knowledge of applicable Federal, State, and local laws/regulations, the Trinity Health’s Integrity and Compliance Program and Code of Conduct, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical, and professional behavior.

MINIMUM QUALIFICATIONS

Must possess a comprehensive knowledge of CPT, ICD-10-CM (ICD-9-CM) and HCPCS level II coding guidelines, along with CCI edits and Medicare claims processing manual contents in a multi-facility, integrated health care delivery system or revenue cycle or consulting experience, as normally obtained through a bachelor’s degree in related field and five (5) to seven (7) years of progressively responsible experience in revenue cycle operations or equivalent combination of education and progressive revenue cycle experience.

Required:  Current standing as a Certified Professional Coder (CPC)

Preferred: Certified E&M Coder (CEMC), and/or Certified Risk Adjustment Coder (CRC). Maintains annual CEU requirement.

Required:  Minimum of three (3) to five (5) years of management experience in a multi-facility, integrated health care delivery system, revenue cycle, or consulting experience. 

Required:  Four (4) to six (6) years of experience in multi-specialty coding, with comprehensive knowledge of Medicare, Medicaid, and other third-party billing rules and regulations. 

Proficiency in Microsoft Office, including Outlook, Word, PowerPoint, and Excel.

Preferred: Experience working within the Epic system, including, coding workflows, Charge Router, Claim Edits and dollars in Pre--AR and AR.

Ability to work collaboratively in a team-oriented environment with a strong customer-service orientation. 

Ability to maintain confidentiality of patient and organizational information.  Ability to prioritize and organize work effectively. 

Ability to exercise independent judgment as appropriate within standard practices and procedures. 

Ability to inspire and motivate others to perform well; accepts feedback; gives appropriate recognition. 

Ability to approach conflict in a constructive manner. 

Ability to identify problems, offer solutions, and participate in their resolution.  Maintains professional development and growth through journals, professional affiliations, seminars, and workshops to keep abreast of trends in revenue cycle operations and healthcare in general:

Participates as appropriate in continuing educational programs and activities that pertain to healthcare and revenue cycle management, as well as specific functional areas.

Develops and implements an annual plan of personal and professional development.

Participates in local, regional, and national health care revenue activities and professionally represents Trinity Health at these functions.

Serves in a leadership role and promotes positive Human Resource Management skills:

Good organizational and time management skills to effectively juggle multiple priorities and time constraints. 

Ability to exercise sound critical thinking, problem-solving and decision-making skills.

Effective verbal, written, and interpersonal communication skills with the ability to comfortably interact with diverse populations.

Ability to work remotely from home following Trinity remote work guidelines.

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.