Remote Hcc Risk Adjustment Jobs in Detroit, MI (NOW HIRING)

Employment Type:
Full timeShift:
Day Shift
Description:
Job Title: Auditor and Educator, Professional Services
Employment Type: Full-time
Shift: Day (Remote)
Location: St. Mary's Medical Center
Position Purpose
Use specialized knowledge to support key areas of the organization related to an area of expertise. Uses data, research analysis, critical thinking & problem-solving skills to support colleagues & leadership in achieving organization's strategic objectives. Serves as a peer influencer & may direct a project or project team by applying industry experience & specialized knowledge
As a "Auditor and Educator" you will:

• Provides high level technical competency & subject matter expertise analyzing coding and documentation review for professional services, including code selection of evaluation and management codes and procedural services.
• Conducts comprehensive audits of professional coders and providers to ensure accuracy, compliance, and alignment with CPT, ICD 10, HCPCS, HCC and payer specific-specific guidelines.
• Analyze documentation and coding patterns to identify risks related to compliance, revenue integrity, and regulatory requirements.
• Provides clear, actionable feedback to providers, coders, and leadership to improve documentation quality and coding accuracy.
• Maintains current knowledge and credentials through ongoing education and interpretation of regulatory and industry changes.
• Develops and delivers targeted education and training programs based on audit findings, regulatory updates, and identified knowledge gaps.
• Provides training and onboarding to new providers.
• Adheres to coding quality & productivity standards as established by Revenue Excellence; Responsible for completion of audit and education workplan as defined by the Service Area Manager of Coding Audit and Education.

Minimum Qualifications:

• Associate degree in Health Information Management or a related field or an equivalent combination of years of education & experience.
• Must possess comprehensive knowledge of ICD-10, HCPCS, CPT, and HCC guidelines, medical terminology, regulatory guidelines including Medicare and Medicaid, and payer policies.
• Three (3) to Five (5) years of professional coding or auditing experience.
• Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Coding Specialist (CCS), or Coding Profession Certification (CPC) is required.

Additional Qualifications (nice to have)

• Bachelor's degree in health information management (HIM) or related healthcare field is preferred
• Preferred prior experience in auditing and provider education.
• Preferred credentials: Certified Professional Medical Auditor (CPMA), Certified Risk Coder (CRC), Clinical Documentation Expert - Outpatient (CDEO).

FT/PT Benefit eligible Roles:
**0.5 FTE (20 hours weekly) up to 1.0 FTE (40 hours weekly)
Position Highlights and Benefits:

• Comprehensive benefit packages, including medical, dental, vision, mental health, paid time off, 403B, education assistance and voluntary benefits (pet insurance, accident insurance, hospital indemnity and others) available from the first day of employment.
• Work/Life balance with flexible schedules.
• Free onsite parking.
• Our mission and core values are what drive each member of Trinity Health to support each other, communicate openly and respectfully while embracing a culture that nurtures a healing, safe environment for all.
• Referral Rewards Program

Position Highlights:

• Work/Life balance with flexible schedules.
• Free onsite parking.
• Our mission and core values are what drive each member of Trinity Health to support each other, communicate openly and respectfully while embracing a culture that nurtures a healing, safe environment for all.
• Referral Rewards Program

St. Mary Medical Center is a beautiful 53-acre state-of-the-art facility comprised of more than 700 physicians, nearly 3,000 colleagues, and 1,100 volunteers committed to providing quality care delivered with compassion and respect. St. Mary attracts top doctors, introduces cutting-edge technologies and implements advanced procedures to meet the healthcare needs of the people it serves, including the nearly 630,000 residents of Bucks County.
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.