Mercy Medical Center Clinton Coding Auditor in Livonia, Michigan
Responsible for performing Inpatient, ED, Complex and Routine Outpatient production coding audits for the System Office Coding Support Services and Trinity Health Regional Health Ministry (RHM) coders. Uses audit results to provide feedback to coders and audit supervisor in order to improve coding. Provides a high level of technical competency and serves as a subject matter expert regarding coding and documentation. Supports the implementation of coding best practices, coding guidelines and policies to ensure compliance with regulatory requirements.
Knows, understands, incorporates and demonstrates the mission, vision and values of Trinity Health in leadership behaviors, practices and decisions.
Maintains a proficient level of knowledge of coding standards along with applicable federal, state and local laws and payer regulations, as well as, applicable policies and procedures in order to ensure adherence in a manner that reflects honest, ethical and professional behavior.
Performs Inpatient, ED and Outpatient coding audits and determines the appropriate response and feedback to coders identifying coding errors and opportunities for improvement. Ensures audits are consistent with, and adhere to Coding Support Services auditing schedules and standards. Provides complete, accurate, concise and timely audit reports to the audit supervisor.
Identifies coding, documentation and compliance opportunities. Communicates and delivers findings of coding errors and documentation improvement opportunities to coders and then to the audit supervisor if there is disagreement over audit findings. Provides subject matter expertise and coding education as needed.
Serves as a resource to those in the Coding Support Services group. Understands the various RHM coding policies and procedures and how to apply them to the coding auditing function.
Uses established audit tools, e.g., worksheet, database, etc., to perform, record and report on production audit findings to the coders and to the audit supervisor. Participates in meetings with Coding Support Services and provides input on how to improve/enhance the production auditing process.
Recommends revisions and enhancements to the audit process as a means to improve efficiencies and effectiveness.
Maintains a working knowledge of applicable Federal, State and local laws, payer regulations, Trinity Health’s Corporate Integrity Program, Standards of Conduct, AHIMA’s Professional Code of Ethics, as well as, other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical and professional behavior
Bachelor’s degree or an equivalent combination of education and experience. Must possess at least one (1) of the following licenses/certifications: RHIA, RHIT, RN, CPC, CCS, or professional certification in another healthcare field.
Minimum of three (3) to six (6) years of inpatient coding and/or complex outpatient coding experience such as ambulatory surgery, or professional services coding in a healthcare setting is required. Must be able to demonstrate proficiency in assignment of ICD diagnosis and procedure coding, or HCPCS/CPT coding, including assignment of E/M codes.
Familiar with official publications and demonstrate the ability to provide documentation that supports regulations quoted in audits.
Knowledge of medical terminology and coding.
Knowledge of Medicare, Medicaid and other third party payer documentation, coding and billing regulations.
Computer skills, especially with Microsoft Word, Access, PowerPoint, and Excel applications. Ability to work remotely and use the Internet and other resource applications for research purposes
Excellent organizational and planning skills, including the ability to prioritize and perform multiple tasks both accurately and simultaneously in a remote working environment. Ability to work with high workload volumes, meet established deadlines and work in a fast paced work environment.
Strong written and verbal communication skills in order to communicate audit findings in clear and concise terms to coders and audit supervisor.
Strong interpersonal skills.
Must possess a personal presence that is characterized by a sense of honesty, integrity and caring with the ability to inspire and motivate others to promote the philosophy, mission, vision, goals and values of CHE Trinity Health.
PHYSICAL AND MENTAL REQUIREMENTS AND WORKING CONDITIONS
Ability to adapt to frequently changing work priorities and schedules.
Work hours may vary based upon assigned projects.
Trinity Health's Commitment to Diversity and Inclusion
Trinity Health employs about 133,000 colleagues at dozens of hospitals and hundreds of health centers in 22 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions.
Trinity Health's dedication to diversity includes a unified workforce (through training and education, recruitment, retention and development), commitment and accountability, communication, community partnerships, and supplier diversity.
Trinity Health is one of the largest multi-institutional Catholic health care delivery systems in the nation, serving diverse communities that include more than 30 million people across 22 states. Trinity Health includes 94 hospitals, as well as 109 continuing care locations that include PACE programs, senior living facilities, and home care and hospice services. Its continuing care programs provide nearly 2.5 million visits annually.
Based in Livonia, Mich., and with annual operating revenues of $17.6 billion and assets of $24.7 billion, the organization returns $1.1 billion to its communities annually in the form of charity care and other community benefit programs. Trinity Health employs about 133,000 colleagues, including 7,800 employed physicians and clinicians.
Committed to those who are poor and underserved in its communities, Trinity Health is known for its focus on the country's aging population. As a single, unified ministry, the organization is the innovator of Senior Emergency Departments, the largest not-for-profit provider of home health care services — ranked by number of visits — in the nation, as well as the nation’s leading provider of PACE (Program of All Inclusive Care for the Elderly) based on the number of available programs. For more information, visit www.trinity-health.org at http://www.trinity-health.org/ . You can also follow @TrinityHealthMI on Twitter.