Employment Type:

Full time

Shift:

Description:

At the direction of the Regional Manager and Supervisor, Coding, this position is responsible for implementation and ongoing activities of the coding quality and compliance plan for the assigned Regional Health Ministries (RHMs).   

 

Performs coding quality reviews as outlined in the coding quality plan; such as by coder, service line, focus area and as otherwise necessary to ensure accurate coding and DRG or APC assignment.  Develops coder education based on results of coding quality reviews, audit results, and regulatory changes.  Provides a high-level of technical competency and serves as a subject matter expert regarding documentation, coding, billing, reimbursement and compliance management as it relates to coding.  Assists with denials management, complex case resolution and may perform coding tasks as directed. 

 

Coordinates and supports correction of errors occurring with coding systems.  Provides coder support via phone or written communications, including in-services and other user group forums.  Provides direction for daily coding assignments and operations.  Responsible for developing and maintaining coding systems training and process documentation.  Assists with training and on-boarding of new coding colleagues.   

 

Work may be onsite and/or remote.   

 

ESSENTIAL FUNCTIONS  

Knows, understands, incorporates and demonstrates the Trinity Health (TH) mission, vision and values of Trinity Health in leadership behaviors, practices and decisions. 

 

Maintains current knowledge of the MS-DRG system, CCs/MCCs, impact on quality, risk of mortality, severity of illness and CMI as well as ICD-10 coding systems and the guidelines related to Clinical Documentation Integrity.  Maintains current knowledge of CPT/HCPCS coding systems and APC assignment. 

 

Provides direction for daily coding assignments and workflow. 

 

Develops and maintains an expert level working knowledge of coding systems, policies, and processes, training courses, materials and certification exercises. 

 

Designs and develops training and education programs that align with end-user needs for components of coding systems and processes. 

 

Coordinates provision of training programs and functions as the trainer/facilitator of coding training programs.  Trains and on-boards new coding colleagues. 

 

Provides user support through phone coverage, written updates and communications, user forums and other available tools and methods. 

 

Conducts auditing and monitoring of coding and abstracting completed by coders.  Communicates