Specialist Charge Revenue Integrity, Cardiology

🕒 Setembro 10

🚗 Michigan – Remoto

🚗 Michigan – Remote

💵 $21 - $32 / hora

⏰ Tempo Integral

🟡 Pleno

🟠 Sênior

🦅 Patrocina Visto H1B

Esta empresa já patrocinou vistos H1B no passado.

👻 Score fantasma 13%

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Trinity Health

SiteLinkedInTodas as Vagas

10.000+ funcionários

🏥 Saúde

📚 Educação

🤝 Sem Fins Lucrativos

Healthcare • Education • Non-profit

A Trinity Health é um dos maiores sistemas de saúde sem fins lucrativos e católicos do país. É uma família de 123.000 colegas e quase 27.000 médicos e clínicos cuidando de comunidades diversas em 26 estados. Reconhecida nacionalmente pelo cuidado e experiência, o sistema Trinity Health inclui 88 hospitais, 135 locais de atendimento contínuo, o segundo maior programa PACE do país, 136 locais de atendimento de urgência e muitos outros serviços de saúde e bem-estar. Com sede em Livonia, Michigan, sua receita operacional anual é de US$ 21,5 bilhões, com US$ 1,4 bilhões retornados para suas comunidades na forma de assistência filantrópica e outros programas de benefícios comunitários.

Descrição

• Research, collect, and analyze information • Identify opportunities, develop solutions, and lead through resolution • Collaborate on performance improvement activities based on program efficiency and patient experience outcomes • Distribute analytical reports • Use multiple system applications to perform analysis, create reports, and develop educational materials • Research and compile information for ad-hoc operational projects and initiatives • Synthesize and analyze data, provide detailed summaries and graphical trend presentations, and recommend practical options or solutions • Leverage program and operational data and measurements to define and demonstrate progress, ROI, and impacts • Ensure accurate CPT/HCPCS documentation for patient billing and educate colleagues and ancillary departments on accurate documentation and appropriate coding • Perform charge capture in assigned Revenue Integrity areas • Thoroughly review charts, including nursing notes, physician orders, progress notes, and surgical or specialty notes, to interpret, validate, and/or extract charges • Verify charges are assigned to the correct patient, encounter, date of service, and required modifiers • Review documentation, abstract data, and ensure charges/coding align with AMA and Medicare coding guidelines • Perform CPT and ICD-10 coding, documentation review, and claim denial review • Work pre-bill edits including OCE/CCI and DNFB within key metrics • Provide at-elbow support to ancillary departments, including supply charge capture, duplicate-charge identification, and communication regarding documentation or charge deficiencies/errors • Perform charge entry, charge approvals, and quality charge reviews, including modifier appending and clinical documentation checks • Provide feedback to intra-departmental Revenue Integrity colleagues on improvement opportunities • Code and/or validate charges for complex service lines and advanced surgical or specialty coding • Educate clinical staff on accurate and complete documentation for revenue optimization and integrity • Follow applicable laws, regulations, Trinity Health compliance requirements, policies, procedures, and guidelines

🎯 Requisitos

• Associate’s degree in healthcare, business administration, finance, accounting, or related field or equivalent experience considered in lieu of degree • RHIA, RHIT, CCS, CPC/COC, AAPC or other coding credentials required • Minimum three (3) years of relevant coding and charge control work experience in a hospital and/or Physician Practice environment • Experience in revenue cycle, billing, coding, and/or patient financial services • Demonstrated knowledge of clinical processes, charge master maintenance, clinical coding (CPT, ICD-10, revenue codes & modifiers), charging processes & audits, and clinical billing • Working knowledge of third-party payer rules and requirements, computer operations, and electronic interfaces related to charge documentation, capture, and billing • Knowledge of charge capture, reconciliation, error management operations, and overall revenue cycle operations • Knowledge of Ambulatory Payment Classification (APC), Outpatient Prospective Payment System (OPPS) reimbursement structures, and prebill edits including OCE/CCI and DNFB • Knowledge of clinical documentation improvement processes strongly preferred • CDC (Healthcare Compliance Certification) preferred • CHRI certification/membership strongly preferred • Ability to follow tasks through to completion, understand and relate to complex ideas/concepts, remember multiple tasks and regimens over long periods, and work on concurrent tasks/projects • Ability to read small print, hear sounds and voice/speech patterns, and give/receive instructions and verbal communications • Ability to use a computer and other technology • Ability to maintain a safe working environment and use available PPE • Ability to provide assistance in an emergency • Ability to lift a maximum of 30 pounds unassisted occasionally • Ability to work indoors under temperature-controlled and well-lit conditions • Ability to comply with Trinity Health’s Code of Conduct, policies, procedures, and guidelines

🏖️ Benefícios

• Remote work position • Equal opportunity employment • Consideration 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