Specialist Charge Revenue Integrity

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🕒 2 dias atrás

🚗 Michigan – Remoto

🚗 Michigan – Remote

💵 $25 - $37 / hora

⏰ Tempo Integral

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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 to support organizational objectives • Identify opportunities, develop solutions, and lead issues through resolution • Collaborate on performance improvement activities • Distribute analytical reports • Use multiple system applications to perform analysis, create reports, and develop educational materials • Compile and synthesize data, provide graphical trend presentations, and recommend practical solutions • Define and demonstrate progress, ROI, and operational impacts • Ensure accurate CPT/HCPCS documentation for patient billing • Educate colleagues, ancillary departments, and clinical staff on accurate documentation and coding • Perform charge capture, charge entry, charge approvals, and quality charge reviews • Review charts and documentation to validate or extract charges • Verify patient, encounter, date-of-service, and modifier accuracy • Abstract data and align charges/coding with AMA and Medicare guidelines • Perform CPT and ICD-10 coding, documentation review, and claim denial review • Work pre-bill edits including OCE/CCI and DNFB • Provide at-elbow support to ancillary departments, including supply-charge review and duplicate-charge identification • Provide feedback to Revenue Integrity colleagues • Code and validate charges for complex service lines and surgical or specialty coding • Maintain compliance with applicable laws, regulations, policies, and the Trinity Health Code of Conduct

🎯 Requisitos

• Associate’s degree in healthcare, business administration, finance, accounting, or related field, or equivalent experience in lieu of degree • RHIA, RHIT, CCS, CPC/COC, AAPC, or other coding credential required • Minimum three years of relevant coding and charge control 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 and charge master maintenance • Knowledge of CPT, ICD-10, revenue codes, and modifiers • Knowledge of charging processes and audits • Knowledge of clinical billing • Working knowledge of third-party payer rules and requirements • Working knowledge of computer operations and electronic interfaces related to charge documentation, capture, and billing • Knowledge of charge capture, reconciliation, error management, and revenue cycle operations • Knowledge of federal, state, and local laws/regulations and Trinity Health compliance policies • CDC healthcare compliance certification preferred • CHRI certification/membership strongly preferred • Knowledge of APC and OPPS reimbursement structures and OCE/CCI pre-bill edits preferred • Knowledge of clinical documentation improvement processes strongly preferred

🏖️ Benefícios

• Remote work position • Equal opportunity employment • Mission-driven, not-for-profit, faith-based healthcare organization