Employment Type:

Shift:

Description:

Purpose

Provides oversight & support of the workflow & functions in accordance with level of experience education & standards. Assumes an expanded role & increased responsibility including delegating to others. Participates in the development of & the process improvement of policies & procedures. Works closely with leadership to maintain efficient & effective operations to ensure quality in daily operations. May partner with leadership with the selection orientation & performance feedback of the team. Works cooperatively to ensure that key customer needs are being met & achievement of operational & performance goals.

Note: patients refers to patients clients residents participants customers members

A review of Pre Go-Live/Implementation support:

• Collaborate with Project Implementation Team on revenue-related discovery.
• Coordinate with coding leadership and physicians to ensure HST memos are distributed.
• Facilitate meet-and-greet sessions between AHS leadership and coding teams.
• Communicate go-live dates and new coding structures to Physician Billing Teams.
• Partner with Regional Patient Access Leadership to identify and resolve gaps in pre-registration and financial clearance.
• Align site processes with enterprise standards and educate on payer selections
• Work with Health Informatics to implement process updates
• Complete HST training across key modules:
  • Patient Access
  • Contracts
  • Code Table Maintenance
  • Item Master modifications
• Support Clairiti instance setup for contracts and estimates
  • Submit tickets to Clariti for contract updates
• Contract Management in HST
  • Collaborate with IT to build or modify payer contracts
  • Partner with local PSPD for contract interpretation
  • Partner with Epic TC team to address contract-related inquiries
  • Mapping contracts to correct payers
• Provide enterprise payer list for site review and customization
• Map payers to transaction codes and contracts
• Ensure item master includes:
  • Correct implant categorization
  • HCPCS and REV codes
  • $0 charge implants
• Educate sites on implant entry during cases and cost assignment in HST

A review of post go-live support:

• Monitor AHS productivity in HST and Epic; send daily/weekly updates.
• Escalate unresolved issues to site leadership:
  • $0 charges (non-implants)
  • Error codes
  • Missing post-op notes
• Manage enterprise code tables and payer configurations:
  • Review and approve SN requests
  • Update HST system with new payer details:
    • Claims address
    • ECS #
    • Financial class
    • Payer type
    • Claim configuration
    • Transaction code assignment
  • Add selections to code tables (e.g. cancellation reasons financial classes)
• Submit SAR requests for new AHS coders across HST Epic TC and Loyola Epic.
• Assist with access-related issues via helpdesk (e.g. password resets login issues)
• Assist Health Informatics in creating or altering processes for optimal flow

Essential Functions

The Revenue Cycle Implementation & Contract Configuration Analyst provides pregolive implementation support and postgolive stabilization for Ambulatory Surgical Centers (ASCs) utilizing HST Epic (TC) and Clairiti. This role partners with Revenue Cycle Patient Access Coding Health Informatics IT Site Administration and Physician Billing teams to ensure accurate payer setup contract configuration code table maintenance item master integrity and operational workflows that support clean claims accurate estimates compliant coding and stable productivity.

Our Trinity Health Culture: Knows understands incorporates & demonstrates our Trinity Health Mission Values Vision Actions & Promise in behaviors practices & decisions.

Work Focus: Coordinates operational technical & / or clerical support services that enhance or improve coordination preparation & flow of the department process & core work. Plans & organizes workflows & prioritizes customers needs. May lead a small team. Serves as a mentor. Creates & maintains procedural standards & records as appropriate for role. Develops & maintains educational programs for the team members including new employee orientation.

Process Focus: Utilizes multiple system applications for data collection & management. Incorporates basic knowledge of Trinity Health policies practices & processes to ensure quality confidentiality & safety are prioritized. Demonstrates knowledge of departmental processes & procedures & ability to readily acquire new knowledge. Collaborate on performance improvement activities as indicated by outcomes in program efficiency & patient experience. Helps to identify opportunities develop solutions & lead the team through resolution.

Communication: Employs effective & respectful written verbal & nonverbal communications. Develops an environment of mutual confidence & trust through collaborative relationships. Effectively communicates goals standards program expectations service performance & how the work serves Trinity Health objectives. Proactively recognizes addresses & / or escalates organizational operational & / or team conflicts.

Environment: Performs work in a caring collaborative & safe manner that complies with regulatory standards.

Maintains a safe functional & organized workspace environment. Stewards productive use of resources (e.g. people financial equipment supplies materials) to achieve assigned commitments experiences & quality standards. Accountable for continuous role-based self-development & leadership growth. Supports the professional growth of team members. Self-monitors & initiates corrections & / or seeks assistance & / or guidance when needed.

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 (not inclusive of titles or advancement career progression)

• Analyzes performance metrics & provides consultation leadership & direction to enhance front-end workflows & improve revenue performance for Trinity Health Medical Groups.
• Partners with medical group operational leaders to improve revenue cycle performance by reviewing weekly metrics assessing root cause analysis & developing / implementing action plans.
• Leads complex projects for practice / clinic locations with focus on ongoing support & continuous improvement; Serves as a consultative resource & develops establishes & manages relationships with executive leaders key stakeholders high-level professionals & decision-makers.
• Reviews front-end denials (eligibility registration & authorizations) for each area & provides feedback to Directors Practice Managers & Supervisors.
• Monitors front office dashboards for significant variances between performance & benchmarks or noticeable drops in performance from one week to the next & partners with operational leaders in developing action plans.

Minimum Qualifications

• Bachelors degree in healthcare administration Business Management Accounting or a related field & / or an equivalent combination of education and experience.
• Valid Drivers License where required by assignment.

Experience (minimum)

3 years of experience in revenue cycle operations patient access billing/claims coding support contract management or revenue integrity with system build/configuration exposure. 1 year supporting implementations golives or postgolive stabilization (can be combined with above).

Systems / Technical

Experience working in one or more of the following areas:

HST (contracts code table maintenance item master)

Epic (especially Epic TC/Resolute or relevant billing components)

Clairiti (contracts and estimates) or comparable estimation/contract tools

Competency using ticketing systems and documentation tools (e.g. ServiceNow/Jira SharePoint/Teams).

Compliance / Operational

Demonstrated ability to handle PHI and follow privacy/security requirements.

Ability to work cross-functionally with IT informatics coding and operational leadership.

Additional Qualifications (nice to have)

• HFMA MGMA AAPC or other healthcare certification preferred.
• Six Sigma or LEAN certification preferred.

Physical & Mental Requirements & Working Conditions (General Summary)

Direct Healthcare Services / Indirect Healthcare / Support Services:

• Exposure to conditions which may be considered unpleasant to sight touch sound & / or smell. Occasional
• Exposure to fumes odors dusts mists & gases biohazards / hazards (mechanical electrical burns chemicals radiation sharp objects etc.).Occasional
• Exposure to or subject to noise infectious waste diseases & conditions. Occasional
• Exposure to interruptions shifting priorities & stressful situations. Frequent
• Ability to follow tasks through to completion understand & relate to complex ideas / concepts remember multiple tasks & regimens over long periods of time & work on concurrent tasks / projects. Continuous
• Ability to read small print hear sounds & voice / speech patterns give / receive instructions & other verbal communications (in-person & / or over the phone / computer / device / equipment assigned) with some background noise. Frequent
• Perform manual dexterity activities & / or grasping / handling. Continuous
• Ability to climb kneel crouch & / or operate foot controls. Occasional
• Use a computer / other technology. Continuous
• Sit with the ability to vary / adjust physical position or activity. Continuous
• Maintain a safe working environment & use available personal protective equipment (PPE). Continuous
• Comply with applicable Code of Conduct policies procedures & guidelines. Continuous
• Ability to provide assistance in the event of an emergency. Occasional

Indirect Healthcare / Support Services:

• Perform activities that require standing / walking with the ability to vary / adjust physical position or activity. Occasional
• Lift a maximum of 30 pounds unassisted. Occasional
• Experience of long periods of walking / standing / stooping / bending / pulling & / or pushing. Occasional
• Encounter a clinical / patient facing / hands on interactive work environment. Occasional
• Work indoors (subject to travel requirements) under temperature-controlled & well-lit conditions. Continuous
• Work outdoors with variable external environmental conditions.Occasional

Average Workday Activity: Occasional - O (1% - 33%) Frequent - F (34% - 66%) Continuous - C (67% - 100%)

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.