Trinity Health

Medical Director

• Provides an effective bridge between RHM management staff and facilities medical staffs to create superior relationships with physicians and to secure physician input into major decisions
• Directly responsible to the CEO for centralized medical staff functions such as medical staff development plan and recruitment, and to the RMH President and other members of the Executive Team for medical directorships at RHM and all physician relationship activities
• Supports the formal medical staff function at all facilities.
• Assists in the development and implementation of the physician Continuous Quality Improvement process throughout the RHM, provides for the functioning and effectiveness of quality improvement systems to include internal and external operating systems that affect the delivery of physician care within the RHM
• Sets a universal standard for the delivery of patient care
• Participates and assists in the development of plans and implementation in all service line and patient care competency development

Chief Medical Officer, CMO

Medical Billing and Coding

• Perform day-to-day billing and follow-up activities in revenue operations
• Document claims billed, paid, settled, and follow-up in appropriate systems
• Identify and escalate issues affecting accurate billing and follow-up
• Contact payers directly for payment due on accounts
• Review and respond to mail correspondence in a timely manner
• Communicate with hospital departments to clarify billing discrepancies
• Investigate overpayments, underpayments, credit balances, and payment delays
• Research claim rejections and make necessary corrections
• Conduct follow-ups on delayed payments
• Prepare special reports as directed by the Supervisor.

Billing and Follow-up Representative, Hospital Medical Billing Follow-up

• Performs the day-to-day billing and follow-up activities within the revenue operations for an assigned Patient Business Services (PBS) location
• Serves as a member of the billing and follow-up team assigned to a PBS location responsible for billing and follow-up of government and non-government accounts
• Provides training and guidance to lower level colleagues and provide problem resolution as needed
• Documents claims billed, paid, settled, and follow-up in appropriate system(s)
• Identifies and escalates issues affecting accurate billing and follow-up activities
• Adheres to proactive practices which includes contacting the payer directly for payment due on accounts and reviewing and responding to all mail correspondence in a timely and accurate manner
• Communicates with appropriate hospital departments to clarify billing discrepancies, and obtain demographic, clinical, financial, and insurance information
• Performs all follow-up functions which includes the investigation of overpayments, underpayments, credit balances and payment delays
• Researches claim rejections, make corrections, take corrective actions, and/or refer claims to appropriate colleagues to ensure timely and accurate claim resolution
• Proactively follow up on delayed payments by contacting patients and third-party payers and determining the cause for delay and supplying additional data as required
• May prepare special reports as directed by the Supervisor Billing and Follow-Up to document follow-up services, e.g., number of claims and dollars billed, claims edited, claims unprocessed, etc.
• Assists in the training and education of Billing and Follow-up Representative I colleagues upon hire and ongoing, and as new systems, processes or payers are created
• Provides problem resolution to billing and follow-up issues as needed
• Maintains a working knowledge of applicable Federal, State, and local laws and regulations, 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.

Billing & Follow-Up Representative II – Hospital Medical Billing Follow-up

• Performs the day-to-day billing and follow-up activities within the revenue operations for an assigned Patient Business Services (PBS) location
• Serves as a member of the billing and follow-up team assigned to a PBS location responsible for billing and follow-up of government and non-government accounts
• Provides training and guidance to lower level colleagues and provide problem resolution as needed
• Documents claims billed, paid, settled, and follow-up in appropriate system(s)
• Identifies and escalates issues affecting accurate billing and follow-up activities
• Adheres to proactive practices which includes contacting the payer directly for payment due on accounts and reviewing and responding to all mail correspondence in a timely and accurate manner
• Communicates with appropriate hospital departments to clarify billing discrepancies, and obtain demographic, clinical, financial, and insurance information
• Performs all follow-up functions which includes the investigation of overpayments, underpayments, credit balances and payment delays
• Researches claim rejections, make corrections, take corrective actions, and/or refer claims to appropriate colleagues to ensure timely and accurate claim resolution
• Proactively follow up on delayed payments by contacting patients and third-party payers and determining the cause for delay and supplying additional data as required
• May prepare special reports as directed by the Supervisor Billing and Follow-Up to document follow-up services, e.g., number of claims and dollars billed, claims edited, claims unprocessed, etc.
• Assists in the training and education of Billing and Follow-up Representative I colleagues upon hire and ongoing, and as new systems, processes or payers are created
• Provides problem resolution to billing and follow-up issues as needed

Billing and Follow-Up Representative II – Hospital Medical Billing Follow-up

• Performs the day-to-day billing and follow-up activities within the revenue operations for an assigned Patient Business Services (PBS) location.
• Serves as a member of the billing and follow-up team assigned to a PBS location responsible for billing and follow-up of government and non-government accounts.
• Provides training and guidance to lower level colleagues and provides problem resolution as needed.
• Documents claims billed, paid, settled, and follow-up in appropriate system(s).
• Identifies and escalates issues affecting accurate billing and follow-up activities.
• Adheres to proactive practices which includes contacting the payer directly for payment due on accounts and reviewing and responding to all mail correspondence in a timely and accurate manner.
• Communicates with appropriate hospital departments to clarify billing discrepancies, and obtain demographic, clinical, financial, and insurance information.
• Performs all follow-up functions which includes the investigation of overpayments, underpayments, credit balances and payment delays.
• Researches claim rejections, makes corrections, takes corrective actions, and/or refer claims to appropriate colleagues to ensure timely and accurate claim resolution.
• Proactively follow up on delayed payments by contacting patients and third-party payers and determining the cause for delay and supplying additional data as required.
• May prepare special reports as directed by the Supervisor Billing and Follow-Up to document follow-up services, e.g., number of claims and dollars billed, claims edited, claims unprocessed, etc.

Billing and Follow-up Representative II – Hospital Medical Billing

Manager

• Deliver skilled nursing care in the comfort of patients’ homes
• Create individualized care plans
• Administer medications
• Educate patients and families

Hospice RN Case Manager, RN

Auditor

• Provides safe, quality health care services & / or assistance to patients under the supervision & direction of a registered nurse or other designated health care professional.
• Performs clinical care activities (direct or indirect) for patients within the “scope of practice” laws & training received.
• Cares for patients safely by assisting in clinical care services or engaging in administrative activities (e.g., maintaining records or supplies).
• Knows, understands & incorporates basic or essential area of practice (document, coordinate, communicate) & training standards.
• Uses clear, effective, respectful language & communication methods / means.

Nurse Auditor – RIO

Analyst

• Working Hours - 1st Shift- 7:30 a.m. to 4:00 p.m. (EDT)
• Must be willing to work rotating weekends every 4th week, plus some holidays
• Perform a variety of activities to identify, investigate, and resolve wrong encounters and documentation errors
• Collaborate with Registration, Billing, clinicians/clinical service lines to resolve documentation errors
• Ensure corrections are completed in a timely, accurate manner to support patient safety
• Direct users to appropriate avenues if requests are not Chart Correction related
• Validate correction of the error and resolve all chart correction cases before closing

Document Creation and Management Chart Integrity Analyst – 1st Shift

Operations

• Manage the integrity of the Health Plan's provider data
• Maintain compliance with Federal and local requirements
• Conduct audits to ensure compliance with CMS requirements
• Produce accurate reports of the plan's provider data for HEDIS purposes
• Identify root causes regarding discrepancies in provider data

Temporary Operations Resolution Specialist – Provider Data Management

• Responsible for ensuring compliance and optimization of the pharmacy 340B program while leading the work of a team and ensuring they meet goals effectively.
• Will lead training and development of Pharmacy 340B staff, manage timekeeping, and participate in performance reviews.
• Lead the development/ongoing maintenance of the 340B program as well as ensure regulatory compliance requirements and support business development activities.
• Will foster a positive team environment and facilitate communication with pharmacy staff, software companies, wholesalers, and pharmaceutical manufacturers.
• Knows, understands, incorporates, and demonstrates the Trinity Health Mission, Vision, and Values in behaviors, practices, and decisions.
• Demonstrates leadership, collaboration, critical thinking, and teamwork when facilitating clinical standards and operational decisions and resolving issues.
• Demonstrates leadership competencies of team building, vision creation, and influence.
• Incorporates changing leadership strategies through building a compelling vision, understanding the perspectives of the stakeholders, identifying tactics to elicit commitment, and addressing resistance.
• Utilizes data to identify opportunities for clinical variation, understands graphical representations of data, and applies project-oriented expertise in identifying leading and lagging metrics for implementation effectiveness, and data plans.
• Demonstrates data-driven approaches for project prioritization and strategies.
• Develops resource utilization strategies to improve organizational performance. Strategies reflect the changing societal and health care environments and the economic climate.
• Advocates for clinical and business innovations that address needs, policy changes, workforce management, 340B education which align with the organizational strategy and national priorities.
• Maintains a working knowledge of applicable Federal, State, and local laws and regulations, Trinity Health’s Organizational Integrity Program, Standards of Conduct, as well as other policies and procedures to ensure adherence in a manner that reflects honest, ethical, and professional behavior.
• Develops, implements, and modifies policies and procedures according to all applicable guidelines/regulations.
• Serves as a liaison to Finance providing 340B program information including utilization, savings, processes, databases, exceptions/discrepancies, and improvement actions.
• Coordinates and prepares operating and capital plans and provides monthly variance analysis for Trinity Health’s Pharmacy business line with a focus on the 340B program.
• Assists with quality control and TPA maintenance.
• Plans, conducts, and reviews monthly self-audits of the hospital-based outpatient 340B program to ensure compliance with the 340B program of policies and procedures.
• Immediately report any discrepancies/deviations to the 340B Program Director.
• Team Management & Development: Overseeing Daily work and performance of the team while providing guidance, coaching, and feedback.
• Ensuring clear communication within team and other departments by facilitating meetings, relaying information, and building/maintaining positive relationships.
• Trouble shooting operational issues and finding solutions in addition to escalating issues to Sr Management when necessary.
• Monitoring team goals against metrics and standard work procedures.
• Performs other duties as requested by supervisor, manager, or department head.

Senior Analyst, 340B

Events

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Mammography Technologist

Human Resources

• HR Operations Consultant serves as a business operations consultant & liaison to HM business line leaders & COEs supporting operations, projects, programs & service delivery outcomes.
• Work activities are performed with direction & oversight from the CHRO/Director HRBP, in collaboration with various organizational levels.
• Provides consultative support to the CHRO/Director HRBP in the implementation of HM business HR strategy, workforce plans, operational services & other initiatives.
• Develops integrated solutions to resolve technical & business issues & strategies which support HR business needs.
• Interfaces with HRSC & TIS HR technology for guidance.

HR Operations Consultant – Onsite

• Perform activities to identify, investigate, and resolve health record documentation errors
• Collaborate with various teams to maintain the integrity of patient records
• Manage Epic Chart Correction InBasket for ambulatory and acute settings
• Ensure timely and accurate completion of chart corrections
• Attend team and departmental meetings and assist with Epic Incoming Messages

Document Creation and Management Chart Integrity Analyst – 2nd Shift

• Provides expert direction and management in HR/Payroll system access
• Acts as a Subject Matter Expert for Workday administration
• Develops efficient processes for customer support
• Manages semi-annual audits of security access
• Utilizes case management system for logging case issues
• Supports team analytics and metrics for management

HR Workday/Help Journey's Specialist

Therapist

• Responsible for performing various therapeutic procedures including advanced practice procedures such as, but not restricted to operating balloon pumps, working in NICU, performing Pulmonary Function testing, “PFT”, etc.
• Provides professional leadership in the delivery of patient care.
• Uses "AIDET" principles when interfacing/treating every patient throughout the organization.
• Provides a consistent experience to patients, families, visitors and internal customers by using "Key Words at Key Times."
• Serves as a consultant, resource person, and role model representing respiratory care in the health system committees or work groups as needed.
• Maintains the confidentiality of information according to HIPPA guidelines.