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Employment Type Full time Shift Day Shift Description ESSENTIAL FUNCTIONS Essential Functions Our Trinity Health Culture: Knows, understands, incorporates & demonstrates our Trinity Health Mission, Values, Vision, Actions & Promise in behaviors, practices & decisions. Leadership Providing advice, guidance, and leadership to RHM and Region leaders in developing strategies and in the achievement of performance goals. Enable Collaboration across and within service area, RHM, and Regions to ensure consistency and integration of strategy and operations. Direction and Growth Providing advice, guidance, and leadership to service area, functional area, RHM, and Regions. Leading standardization/systemness and optimization of policy, process, methodology, establishing a national community of practice. Oversee Vendor/Contract Labor Management including centralizing strategy and optimizing spend. Strategic Support & Accountability Collaborates in system-wide strategy development and deployment of functional area priorities and initiatives. Responsible for supporting regional efforts to comply with functional area priorities. Accountable for the selection, evaluation, and overall success of the functional leadership teams Organization-wide focal point for establishing functional strategies and governance over financials and staffing. Accountable for communication between service area functional area, RHM, and Regions leader Operational Delivery Responsible for measuring and reporting KPIs/metrics and value delivery. Providing advice, guidance, and leadership for the colleague life cycle 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 Analyzes service area denials trends presented by recovery coordinators to determine impact, develop denials prevention action plans, and support denials prevention projects to ensure effectiveness and monitor overall reduction of denials Supports recovery coordinators in preparation for weekly denials prevention meetings and then attend meetings across all HMs to provide oversight and means of escalation for all denials prevention initiatives. Provides feedback to recovery coordinators for next steps or redirection as needed. Provides insight into higher level-cross departmental interventions effort updates. Reports out weekly/monthly to senior leadership on trends related to initial denials. Provides updates on primary high-impact interventions and escalates barriers to resolution. Works in conjunction with EPFS leadership and analysis teams to review and discuss OWO trends and identify related denials trends. Maintains an understanding of regulatory and payer changes to assure correct charging and billing requirements are met. COMPENSATION RANGE: $47.2309 - $70.8464 FULL-TIME REMOTE ROLE EST ZONE WORK HOURS Minimum Qualifications Bachelor’s degree in business or healthcare administration, Education, Learning and Development, Five (5) to seven (7) years of revenue cycle experience. Billing, Coding, PA, Revenue Integrity, collections, etc. Certification and membership in AAPC, AHIMA, HFMA, AAHAM, NAHAM strongly preferred Knowledge of insurance and governmental programs, regulations, and billing processes (e.g., Medicare, Medicaid, managed care contracts and coordination of benefits) Additional Qualifications (nice To Have) Master’s degree in related field, preferred Understands Revenue Cycle Key Performance Indicators and can identify vulnerabilities related to quality performance. Working knowledge of denials related software technology strongly preferred. Physical & Mental Requirements & Working Conditions (general Summary) Direct Healthcare Services / Indirect Healthcare / Support Services: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.
Our Commitment to Diversity and Inclusion Trinity Health is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians across 25 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. Our dedication to diversity includes a unified workforce (through training and education, recruitment, retention, and development), commitment and accountability, communication, community partnerships, and supplier diversity. EOE including disability/veteran If you have questions about this posting, please contact support@lensa.comTITLE: Workers Compensation Case Manager/Paralegal SALARY: Competitive salary commensurate with experience REQUIREMENTS: High School Diploma; Paralegal associate degree ...
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