Specialist, Charge Revenue Integrity

🕒 Agosto 21

🚗 Michigan – Remoto

🚗 Michigan – Remote

💵 $25 - $37 / hora

⏰ Tempo Integral

🟡 Pleno

🟠 Sênior

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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 • Utilize multiple system applications to perform analysis, create reports, and develop educational materials • Research and compile information to support ad-hoc operational projects and initiatives • Synthesize and analyze data, provide detailed summaries and graphical presentations illustrating trends, 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 coding functions including CPT and ICD-10 assignment, 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, ensuring appropriate supply and implant charges, identifying duplicate charges, and addressing documentation or charge deficiencies/errors • Perform charge entry, charge approvals, and quality charge reviews, including appending modifiers and checking clinical documentation • Provide feedback to Revenue Integrity colleagues on improvement opportunities • Code and/or validate charges for complex service lines, including advanced surgical or specialty coding • Educate clinical staff on accurate and complete documentation to optimize revenue integrity

🎯 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, and modifiers), charging processes and 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 APC, OPPS reimbursement structures, and prebill edits including OCE/CCI edits and DNFB • Knowledge of clinical documentation improvement processes strongly preferred • CDC healthcare compliance certification preferred • CHRI certification/membership strongly preferred • Ability to use computers and other technology • Ability to lift a maximum of 30 pounds unassisted occasionally • Ability to maintain a safe working environment and use available PPE • Ability to provide assistance in an emergency occasionally

🏖️ Benefícios

• Remote work position • Equal Opportunity Employer commitment