Encounter Data Integrity Specialist- Full-time, 40 Hours/week

Encounter Data Integrity Specialist
Huron Valley PACE
Thome PACE

Status: Full-time, 40 hours/week
PACE Center Hours: Monday-Friday, 8:00a-4:30p

PACE® is a program that fulfills a wide range of healthcare needs of the elderly within the familiarity and comfort of their own homes and community. Through PACE®, teams of healthcare professionals who specialize in working with the senior community help participants and their family members make positive healthcare decisions and receive the care they deserve.

Join our team of compassionate and skilled staff and love your career!

Benefits: Be part of an organization that values their team members and knows the importance of providing a supportive community. PLUS - Affordable and layered benefit plans for individuals that are hired for 30 or more hours/week, Voluntary benefit options (including Life Insurance) for team members hired for 16-29 hours/week, Retirement Savings Plan (with potential employer match), Wellness Initiatives, Education Tuition Assistant, 5 STAR staff rating, Paid Time Off, 6 Paid Holidays per year PLUS a paid Floating Holiday and a paid Birthday Holiday, DAILYPAY, and MORE!

Job Summary:
The Encounter Data Integrity Specialist will be responsible for the capture and submission of all qualifying billable encounters. The specialist will ensure all billable encounters are captured in a timely manner and all team members are trained appropriately to enter information accurately in the electronic medical record. This position will train team members and interact with clinicians and the management team. Position will support Huron Valley PACE in Ypsilanti and Thome PACE in Jackson. Occasional travel between sites will be required.

Primary Responsibilities:
Support the production of encounter data submissions to MDHHS
Review documented encounters to assign all applicable CPT and ICD-10 codes
Conduct staff training related to documentation requirements and timely completion
Provide quality monitoring and oversight of submitted encounter codes
Prepare encounter files for submission
Review encounter return files and perform necessary adjustments for resubmission
Assist in developing and maintaining encounter data reports for internal quality standards and compliance
Assist with the development and review of internal policies and procedures related to internal encounter claims
Identifies and works to resolve systematic barriers to the submission of encounter based data

• Must be able to read, write, speak and understand the English language and follow written and oral instructions.
• Must display patience, tact, a positive disposition, and enthusiasm, as well as be willing to work with a variety of participants with varying cognitive levels.

• Know, teach and live out the Mission, Guiding Beliefs of UMRC.
• Manage from a position of compassion, passion and servitude.
• Customer Service is key to relationships within and outside the organization. Make this a program achievement.

Every effort has been made to identify the essential functions of this position. However, this in no way states or implies that these are the only duties you will be required to perform. The omission of specific statements of duties does not exclude them from the position if the work is similar, related, or is an essential function of the position.

Required Qualifications:
High School Diploma or GED required
Minimum of one (1) year working with the frail, elderly or long-term care population
Must possess a current State of Michigan driver’s license and maintain an acceptable driving record
Prior experience in medical billing and coding required
Professional verbal and written communication skills required

Desired Qualifications:
Knowledge of CPT and ICD-10 codes required, certification preferred
Previous experience in managed care preferred

Disclaimer

UMRC & Porter Hills are a federally funded program through CMS and the State of Michigan. All employees are expected to adhere to the Participant Rights.

UMRC & Porter Hills provide equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability or genetics in accordance with applicable federal, state and local laws.