Charge Revenue Integrity Specialist

🔥 0 minutes ago

🚗 Michigan – Remote

🚗 Michigan – Remote

💵 $25 - $37 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 0%

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Trinity Health

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

🤝 Non-profit

🏨 Hospitality

🔥 Funding within the last year

💰 $20k Grant - Trinity Health on 2025-10

Healthcare • Non-profit • Hospitality

Trinity Health is one of the largest not-for-profit, faith-based healthcare systems in the United States. With approximately 127,000 colleagues and over 38,300 physicians and clinicians, it provides a wide range of medical services and care to diverse communities across 26 states. The organization emphasizes its mission-driven, faith-based values, community impact, employee benefits, and career opportunities including travel nursing through its FirstChoice program. Headquarters are listed in Livonia, Michigan. Trinity Health focuses on patient care, community health, and supporting a large workforce of clinical and non-clinical staff.

📋 Description

• 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 • Analyze data and provide detailed summaries with graphical trend presentations and practical recommendations • Leverage program and operational data to define and demonstrate progress, ROI, and impacts • Ensure accurate CPT/HCPCS documentation for patient billing and educate colleagues and ancillary departments on documentation and coding • Perform charge capture in assigned Revenue Integrity areas • Review charts and documentation to interpret, validate, and extract charges • Verify charges against the correct patient, encounter, date of service, and required modifiers • 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 deficiency/error communication • Perform charge entry, approvals, and quality charge reviews, including modifiers and clinical documentation checks • Code and/or validate charges for complex service lines and surgical or specialty coding • Educate clinical staff on accurate and complete documentation for revenue optimization and integrity • Maintain knowledge of applicable laws, regulations, Trinity Health compliance requirements, policies, procedures, and guidelines

🎯 Requirements

• 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 • CDC certification preferred • CHRI certification/membership strongly preferred • Knowledge of APC, OPPS reimbursement structures, OCE/CCI edits, and DNFB • Knowledge of clinical documentation improvement processes strongly preferred