Charge Specialist, Revenue Integrity

🔥 13 hours ago

🚗 Michigan – Remote

🚗 Michigan – Remote

💵 $21 - $32 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

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Trinity Health

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

📚 Education

🤝 Non-profit

Healthcare • Education • Non-profit

Trinity Health is a Christian K-12 educational institution located in Wichita, Kansas, dedicated to providing a Christ-centered education that nurtures spiritual growth and academic excellence. The academy emphasizes the importance of faith in students' lives, integrating spiritual development with rigorous academic programs and a broad array of extracurricular activities, including athletics and fine arts. Trinity Health fosters a supportive community where teachers and families collaborate to help students develop a personal relationship with Jesus Christ and excel in their studies.

📋 Description

• Research, collect, analyze, and synthesize information to support operational projects and initiatives • Identify opportunities, develop solutions, and lead issues through resolution • Collaborate on performance improvement activities related to program efficiency and patient experience • Distribute analytical reports • Utilize multiple system applications to perform analysis, create reports, and develop educational materials • Ensure quality, confidentiality, and safety through knowledge of policies, practices, and processes • Prepare detailed summaries with graphical data presentations illustrating trends and recommending practical solutions • 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 accurate documentation and coding • Perform charge capture in assigned Revenue Integrity areas • Review charts and clinical documentation 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 align charges/coding with AMA and Medicare coding guidelines • 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 validation, duplicate-charge identification, and deficiency/error communication • Perform charge entry, charge approvals, quality charge reviews, modifier appending, and clinical documentation checks • Provide feedback to Revenue Integrity colleagues on improvement opportunities • Code and/or validate charges for complex service lines and advanced surgical or specialty coding • Educate clinical staff on accurate and complete documentation for revenue optimization and integrity

🎯 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 & requirements, computer operations & electronic interfaces related to charge documentation, capture & billing • Knowledge of charge capture, reconciliation, error management operations & overall revenue cycle operations • CDC (Healthcare Compliance 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 • Ability to follow complex tasks through to completion and work on concurrent tasks/projects • Ability to use a computer/other technology and maintain a safe working environment • Ability to lift a maximum of 30 pounds unassisted occasionally