Revenue Integrity Recovery Coordinator

🕒 vor 18 Tagen

🔔 Pennsylvania – Remote

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⏰ Vollzeit

🟡 Mittelstufe

🟠 Senior

🦅 H1B-Visum-Sponsor

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👻 Geisterscore 10%

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🗣️🇺🇸🇬🇧 Englisch erforderlich

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Logo of Trinity Health

Trinity Health

10.000+ Mitarbeiter

🏥 Gesundheitswesen

📚 Bildung

🤝 Non-Profit

Healthcare • Education • Non-profit

Trinity Health ist eines der größten gemeinnützigen katholischen Gesundheitssysteme in den USA. Es ist eine Gemeinschaft von 123.000 Kollegen und fast 27.000 Ärzten und Klinikern, die sich in 26 Bundesstaaten um vielfältige Gemeinschaften kümmern. National anerkannt für Pflege und Erfahrung umfasst das Trinity Health-System 88 Krankenhäuser, 135 Pflegeeinrichtungen, das zweitgrößte PACE-Programm des Landes, 136 Notfallzentren und viele weitere Gesundheits- und Wohlfühldienste. Mit Sitz in Livonia, Michigan, beläuft sich der jährliche Betriebsumsatz auf 21,5 Milliarden US-Dollar, von denen 1,4 Milliarden US-Dollar in Form von Wohlfahrtspflege und anderen gemeinnützigen Programmen an die Gemeinschaften zurückgegeben werden.

Beschreibung

• Perform in-depth analysis of patient clinical and billing data to identify documentation, coding, and denial prevention opportunities • Develop and implement denial-prevention action plans based on root-cause analysis • Coordinate complex denials with intra-team members to identify root causes • Analyze data and report trends, performance metrics, process improvements, and revenue impact • Provide education, process improvement, ongoing assessment, and resolution of root-cause issues • Conduct departmental audits for documentation and compliance with state and federal guidelines related to charge capture and billing • Prepare and submit audit findings, make recommendations, and implement solutions with revenue integrity and inter-departmental leaders • Collaborate with clinical departments, Patient Business Service, Payer Strategies, Compliance, and other revenue cycle departments on denial coordination and prevention • Support system implementations, enhancements, and new service-line requests to ensure revenue cycle integrity and compliance • Develop processes with ancillary teams and providers to prevent future denials • Track potential risk accounts and review with Finance for impacts to reserves and the Bad Debt Charity Operational write-offs model • Complete assigned reports accurately and on time • May assist the centralized charge control team and travel between locations within the Region

🎯 Anforderungen

• Bachelor's degree in Healthcare or Business Administration, Finance, Accounting, Nursing, or a related field, or an equivalent combination of education and experience • Five (5) or more years of experience in billing, charge documentation, charge audit, charge capture, or related revenue cycle activities • Demonstrated knowledge of clinical processes, charge master maintenance, clinical coding (CPT, HCPCS, ICD-9/10, revenue codes, and modifiers), charging processes and audits, and clinical billing • Proficiency with MS Excel, Access, and Business Objects highly desired • Strong competency with Word and PowerPoint • Working knowledge of third-party payer rules and requirements, computer operations, and electronic interfaces related to charge documentation, capture, and billing • Knowledge of Ambulatory Payment Classification (APC), Outpatient Prospective Payment System (OPPS), prebill edits, OCE/CCI edits, and DNFB • Experience with post-payment audits and coding, clinical, and technical denials required • RHIA, RHIT, CCS, CPC/COC, or other coding credentials strongly preferred • CDC (Healthcare Compliance Certification) and CHRI preferred • Exceptional organizational, analytical, interpersonal, verbal, and written communication skills • Ability to prioritize and manage multiple functions and responsibilities simultaneously • Accuracy, attentiveness to detail, and time-management skills • Ability to work collaboratively in a shared-leadership environment • Must possess honesty, integrity, caring, and the ability to promote Trinity Health's mission, vision, goals, and values

🏖️ Vorteile

• Comprehensive benefit packages, including medical, dental, vision, mental health, paid time off, 403B, education assistance and voluntary benefits (pet insurance, accident insurance, hospital indemnity and others) available from the first day of employment • Work/Life balance with flexible schedules • Free onsite parking • Referral Rewards Program

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