Work where every moment mattersEvery day over Hartford HealthCare colleagues come to work with one thing in common Pride in what we do knowing every moment matters here We invite you to become part of Connecticutrsquos most comprehensive healthcare networkThe creation of the HHC System Support Office recognizes the work of a large and growing group of employees whose responsibilities are continually evolving so that we and our departments now work on behalf of the system as a whole rather than a single member organizationWith the creation of our new umbrella organization we now have our own identity with a unique payroll benefits performance management system service recognition programs and other common practices across the system Position SummaryThe Professional Billing Audit Education Team Lead is responsible for supporting the daily operations and strategic direction of the audit and education team This role also supports development and implementation of a comprehensive audit and education program that aligns with regulatory contractual and professional standards as well as healthcare revenue cycle industry practices The Team Lead provides guidance mentorship and quality oversight to Audit Education Specialists while also performing audits delivering education and supporting documentation practices that comply with CMS guidelines risk adjustment requirements and ICD coding standards Position ResponsibilitiesKey Areas of ResponsibilityAudit and Education Performs revenue opportunity assessment and executes the professional audit work plan which includes provider audit and education Compiles and prepares complex reporting from internal vendor and AI sources for distribution to key stakeholders Analyzes audit results creates training material and performs education and training for providers and staff Tracks performance patterns and results Disseminates results to key stakeholders Researches guidance from regulatory groups such as HHSOIG Medicare Medicaid NGS etc professional and peer organizations practicespoliciesguidelines to keep organization current with regulatory requirements and accepted audit and education practices Creates education to support Medicare Risk Adjustment initiatives Partners with providers to influence accurate and compliant documentation practices Reviews and provides feedback on education materials Works to identify and resolve team and customer issuesCommunication Collaborate with other departments Coding Revenue Integrity etc to achieve expected outcomes Seeks clarification from providers where documentation is absent ambiguous or contradictory and makes appropriate correctionsTeam Support Provides day to day operational support to the Audit and Education team ensuring alignment with organizational goals and regulatory standards Onboards new Audit and Education team colleagues Provides ongoing feedback assists with coaching mentoring recruiting developing and retaining Audit and Education Specialists Provides continuing education for the Audit and Education Specialist and tracks requirements for job role and credentialing Completes additional assignments and special projects as requested Working RelationshipsThis Job Reports To Job Title Audit and Education ManagerWork where every moment mattersEvery day over Hartford HealthCare colleagues come to work with one thing in common Pride in what we do knowing every moment matters here We invite you to become part of Connecticutrsquos most comprehensive healthcare networkThe creation of the HHC System Support Office recognizes the work of a large and growing group of employees whose responsibilities are continually evolving so that we and our departments now work on behalf of the system as a whole rather than a single member organizationWith the creation of our new umbrella organization we now have our own identity with a unique payroll benefits performance management system service recognition programs and other common practices across the system Position SummaryThe Professional Billing Audit Education Team Lead is responsible for supporting the daily operations and strategic direction of the audit and education team This role also supports development and implementation of a comprehensive audit and education program that aligns with regulatory contractual and professional standards as well as healthcare revenue cycle industry practices The Team Lead provides guidance mentorship and quality oversight to Audit Education Specialists while also performing audits delivering education and supporting documentation practices that comply with CMS guidelines risk adjustment requirements and ICD coding standards Position ResponsibilitiesKey Areas of ResponsibilityAudit and Education Performs revenue opportunity assessment and executes the professional audit work plan which includes provider audit and education Compiles and prepares complex reporting from internal vendor and AI sources for distribution to key stakeholders Analyzes audit results creates training material and performs education and training for providers and staff Tracks performance patterns and results Disseminates results to key stakeholders Researches guidance from regulatory groups such as HHSOIG Medicare Medicaid NGS etc professional and peer organizations practicespoliciesguidelines to keep organization current with regulatory requirements and accepted audit and education practices Creates education to support Medicare Risk Adjustment initiatives Partners with providers to influence accurate and compliant documentation practices Reviews and provides feedback on education materials Works to identify and resolve team and customer issuesCommunication Collaborate with other departments Coding Revenue Integrity etc to achieve expected outcomes Seeks clarification from providers where documentation is absent ambiguous or contradictory and makes appropriate correctionsTeam Support Provides day to day operational support to the Audit and Education team ensuring alignment with organizational goals and regulatory standards Onboards new Audit and Education team colleagues Provides ongoing feedback assists with coaching mentoring recruiting developing and retaining Audit and Education Specialists Provides continuing education for the Audit and Education Specialist and tracks requirements for job role and credentialing Completes additional assignments and special projects as requested Working RelationshipsThis Job Reports To Job Title Audit and Education ManagerEducationmiddot Minimum Associatersquos Degree or equivalent experiencemiddot Preferred Baccalaureate degree not required but preferredExperience middot Minimumo Eight years experience witho CPT HCPCS and ICD coding conventions requiredo Experience with interpreting Medicare Medicaid and third party billing and compliance regulationso Experience with Claim Submission requirementso Experience analyzing data reviewing results and creating appropriate mitigating action planso Exemplary communication skills ability to navigate challenging conversations and provide effective provider training in large and small groupso Effectively able to influence providers to improve documentationo Experience in project managemento Progressively responsible leadership responsibilities middot Preferredo Minimum of ten years experienceo Experience working in an educational training role preferredLicensure Certification Registration middot Minimumo Medical Coding License required CPC or CCS P or CCSo And CPMAo And CRCPreferredo CCDS Certified Clinical Documentation Specialist oro CPCO Certified Professional Compliance Officer oro CDIP Certified Documentation Integrity ProfessionalKnowledge Skills and Ability RequirementsExtensive Knowledge ofmiddot ICD CM diagnostic and CPTHCPCS procedure codesmiddot Clinical information related to areas of responsibilitySkillsmiddot Read write and speak English proficientlymiddot Strong analytical and critical thinking capabilitiesmiddot Excellent organizational skillsmiddot Proficiently read and interpret physician documentationmiddot Experience with Word Excel and PowerPointmiddot Knowledge of business systems eg EpicStrong ability tomiddot Function independentlymiddot Handle multiple prioritiesmiddot Deliver results individually and through a teammiddot Delegate tasks effectively to othersmiddot Create a positive learning environmentmiddot Practice active listeningmiddot Communicate clearly using appropriate verbal and body languagemiddot Collaborate with others to achieve a common goal through mutual cooperationmiddot Influence others for positive and productive outcomesmiddot Work across the Hartford HealthCare Systemmiddot Work on site as neededmiddot Thrive in a fast paced business environment handling multiple prioritiesmiddot Demonstrate HW Leadership Behaviors We take great care of careers With locations around the state Hartford HealthCare offers exciting opportunities for career development and growth Here you are part of an organization on the cutting edge ndash helping to bring new technologies breakthrough treatments and community education to countless men women and children We know that a thriving organization starts with thriving employees we provide a competitive benefits program designed to ensure worklife balance Every moment matters And this isyour moment Educationmiddot Minimum Associatersquos Degree or equivalent experiencemiddot Preferred Baccalaureate degree not required but preferredExperience middot Minimumo Eight years experience witho CPT HCPCS and ICD coding conventions requiredo Experience with interpreting Medicare Medicaid and third party billing and compliance regulationso Experience with Claim Submission requirementso Experience analyzing data reviewing results and creating appropriate mitigating action planso Exemplary communication skills ability to navigate challenging conversations and provide effective provider training in large and small groupso Effectively able to influence providers to improve documentationo Experience in project managemento Progressively responsible leadership responsibilities middot Preferredo Minimum of ten years experienceo Experience working in an educational training role preferredLicensure Certification Registration middot Minimumo Medical Coding License required CPC or CCS P or CCSo And CPMAo And CRCPreferredo CCDS Certified Clinical Documentation Specialist oro CPCO Certified Professional Compliance Officer oro CDIP Certified Documentation Integrity ProfessionalKnowledge Skills and Ability RequirementsExtensive Knowledge ofmiddot ICD CM diagnostic and CPTHCPCS procedure codesmiddot Clinical information related to areas of responsibilitySkillsmiddot Read write and speak English proficientlymiddot Strong analytical and critical thinking capabilitiesmiddot Excellent organizational skillsmiddot Proficiently read and interpret physician documentationmiddot Experience with Word Excel and PowerPointmiddot Knowledge of business systems eg EpicStrong ability tomiddot Function independentlymiddot Handle multiple prioritiesmiddot Deliver results individually and through a teammiddot Delegate tasks effectively to othersmiddot Create a positive learning environmentmiddot Practice active listeningmiddot Communicate clearly using appropriate verbal and body languagemiddot Collaborate with others to achieve a common goal through mutual cooperationmiddot Influence others for positive and productive outcomesmiddot Work across the Hartford HealthCare Systemmiddot Work on site as neededmiddot Thrive in a fast paced business environment handling multiple prioritiesmiddot Demonstrate HW Leadership Behaviors We take great care of careers With locations around the state Hartford HealthCare offers exciting opportunities for career development and growth Here you are part of an organization on the cutting edge ndash helping to bring new technologies breakthrough treatments and community education to countless men women and children We know that a thriving organization starts with thriving employees we provide a competitive benefits program designed to ensure worklife balance Every moment matters And this isyour moment