The Data Integrity Specialist (DIS) is responsible for assisting with revenue cycle performance improvement initiatives by providing analytical and operational support to the Director of Patient Access & Financial Services and management staff. Collects, compiles and presents weekly/monthly statistical information on department and staff productivity and performance, insurance denials, wrong encounter and uncompensated care trends to leadership. Responsible for identifying performance trends, analyzing these trends through detailed account reviews and preparing recommendations to management regarding areas requiring process improvement or additional training needs. Updates registrations held due to incorrect and/or missing data (DNFB review, denial follow-up and pre-bill edits) and audits registrations in order to ensure data integrity and compliance of process guidelines. Responsible for working error reports returned from electronic eligibility vendor and correcting patient accounts within the bill hold timeframe ensuring timely claims processing. Identifies duplicate medical records numbers, notifies and coordinates the remediation with Health Information Management and other affected departments. Provides subject matter expert support to training staff including orientation and continuing education. The successful candidates for this position are energetic, highly motivated professionals who perform well in a multi-faceted and fast-paced environment both independently and as part of an interdisciplinary team.
JOB DUTIES
Actively demonstrates the organization’s mission and core values, and conducts oneself at all times in a manner consistent with these values. Knows and adheres to all laws and regulations pertaining to patient health, safety and medical information. Responsible to work daily reports of registration errors and update accounts prior to bill drop date, which may include incorrect ICO selection, eligibility errors, missing MSPs, NPI errors, etc. Researches, reviews and corrects wrong encounters which may include duplicate medical records, incorrect demographic/insurance information, charges posted to the wrong visit or registering the wrong patient. Acts as point of contact for nursing / clinical staff and updates HealthQuest with correct information when informed of wrong encounters by clinical staff. Notifies various departments such as Health Information Management and Utilization/Case Management of material changes to the corrected insurance and demographic information that may affect their processes. Include or make reference to unit-specific and patient-age specific duties. These are often kept separately in departmental competency assessment records. Utilizes and validates information from multiple internal and external computer sources, such as various payers, Patient Access and Patient Accounting systems, to ensure data accuracy. Performs activities that relate to data reviews, quality assurance and training support activities for Pre-Service and Patient Access staff. Develops and performs audit procedures to measure and monitor staff proficiency and to ensure optimal data integrity, including the auditing of Pre-Service and Patient Access activities, reconciliation and documentation of results to ensure quality improvements. Procedures will include the analysis of data screens, edit reports (DNFB, denial follow-up, pre-bill edits, etc.), source documents, batch proofs, ability to develop custom analytical reports, as well as the interpretation of audit data, display of errors, statistical trend analyses, and the creation of management ready presentations with recommendations of potential process/system changes for leadership review. Provides learning and application support to Training Specialists and associates in the use of revenue cycle systems and processes within traditional classroom settings, as well as decentralized locations and one-on-one interactions. Must possess teaching skills that enhances user learning and involvement. Ability to convey complicated information to end-users in a concise, user-friendly manner that ensures user competency and process compliance, while energizing users’ discussion and input (may include the preparation of training and assessment materials). Provides Patient Access user support to facilitate health services delivery/patient care by responding to user inquiries in a timely, effective manner, analyzing issue(s), identifying common trends, formulates plans to address each issue, and communicates process enhancements and analysis results with MO/SSC leadership and the Training Specialists. May serve as relief support to peers, if work schedule permits. Relief functions include, but are not limited to Registration and Pre-Service. Performs other duties consistent with purpose of job as directed.
JOB SPECIFICATIONS AND CORE COMPETENCIES
Education: High school diploma required. Associate’s Degree or an equivalent combination of years of education and experience with performance analysis and data entry skills (50-60 keystrokes per minutes). Demonstrated knowledge of Medical Terminology, Statistical Analysis and other related coursework is desired to meet job requirements.
Licensure: Certified Healthcare Access Associate (CHAA) credentials by the National Association of Healthcare Access Management (NAHAM) and/or Certified Patient Account Technician (CPAT) credentials by the American Association of Healthcare Administrative Management (AAHAM) is also preferred.
Experience: Past work experience of at least 3 years in a healthcare setting or financial service setting in a position performing analytical data reviews and training activities is required.
Other Job Requirements: Excellent communication (verbal and written) and organizational abilities. Interpersonal skills are necessary in dealing with internal and external customers, including the ability to interpret customer requirements, recommend and take action to satisfy the customer’s needs. Accuracy, attentiveness to detail and time management skills are required.
Completion of regulatory/mandatory certifications and skills validation competencies preferred.
Process improvement/resolution and data analysis experience and/or training preferred.
Windows-based software proficiency required, knowledge of hospital scheduling and registration, charge capture, billing and collection practices, third party payers, strong analytical skills, and effective oral and written communication skills are required.
Experience identifying and understanding issues, problems and opportunities; comparing data from different sources to draw conclusions; using effective approaches for choosing a course of action or developing appropriate solutions; taking action that is consistent with available facts and Trinity Health guiding behaviors.
Must be comfortable operating in a highly collaborative, shared leadership environment.
Must be able to demonstrate creative coaching and counseling skills when dealing with education and development issues.
Must be able to work concurrently on a variety of tasks/projects in an environment that may be stressful with individuals having diverse personalities and work styles. Excellent problem solving skills are essential.
Assigned hours within your shift, starting time, or days of work are subject to change based on departmental and/or organizational needs.
Our Commitment to Diversity and Inclusion
Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is 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, status as a protected veteran, or any other status protected by law.