Specialist, Charge Revenue Integrity

🕒 vor 14 Tagen

🚗 Michigan – Remote

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💵 $25 - $37 / Stunde

⏰ 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

• 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

🎯 Anforderungen

• 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

🏖️ Vorteile

• Remote work position • Equal Opportunity Employer commitment

Jetzt Bewerben

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