Revenue Integrity Charge Specialist

🔥 0 minutes ago

🚗 Michigan – Remote

🚗 Michigan – Remote

💵 $24 - $36 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

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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

• Ensure accurate CPT and/or ICD-10 documentation for patient billing and educate colleagues and providers on accurate documentation and coding • Maintain documentation regarding charge capture processes and review process adherence for missing charges • Coordinate with stakeholders on system change requests and process upgrades • Oversee charge reconciliation processes for assigned departments, including daily and monthly reconciliations • Perform charge entry, charge approvals, quality charge reviews, modifier appending, and clinical documentation checks • Code and validate charges for complex service lines, including surgical or specialty coding • Review charts and documentation to interpret, validate, and extract charges; verify patient, encounter, date of service, and modifiers • Abstract data and ensure coding alignment with AMA, Medicare, Federal, State, and private payer requirements • Perform CPT and ICD-10 coding, documentation review, claim denial review, and daily charge proofing for clean claim submission • Balance charges and adjustments while maintaining productivity standards • Assist with denial coordination, clinical documentation analysis, root cause analysis, and tracking • Educate clinical staff on complete documentation and revenue optimization • Research charges, communicate findings, and create charge capture reference materials • Review quality reports for missing, duplicate, and late charges; maintain logs and reporting tools • Perform reconciliation and provide at-elbow support to ancillary departments, including supply and implant charge review • Maintain patient confidentiality and perform other duties as assigned

🎯 Requirements

• Demonstrated knowledge of clinical processes, charge master maintenance, clinical coding (CPT, ICD-10, revenue codes and modifiers), charging processes and audits, and clinical billing • Bachelor's or associate degree in Healthcare or Business Administration, Finance, Accounting, Nursing, or a related field • 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 • Strong working knowledge of medical terminology, data entry, supply chain processes, and hospital and/or Medical Group practice operations • RHIA, RHIT, CCS, CPC/COC or other coding credentials and/or Licensed Vocational Nurse/Licensed Practical Nurse licensure required • Strong understanding of medical claim formats • Strong knowledge of APC, OPPS reimbursement structures, OCE/CCI edits, and DNFB • Ability to perform charge capture processes and investigate charge errors; Epic experience desired • Experience and knowledge of working on appeals for insurance denials and identifying root cause • Knowledge of hospital and/or physician group practice revenue cycle front-end and back-end functions • Ability to organize and prioritize work in a diverse, fast-paced environment while working on multiple projects simultaneously • Strong problem-solving, analytical, interpersonal, verbal, and written communication skills • Knowledge of billing and regulatory guidelines related to charging and revenue cycle processes • Experience with MS Excel, Word and PowerPoint preferred • Must be comfortable operating in a collaborative, shared leadership environment • Maintains working knowledge of applicable Federal, State, and Local laws and regulations and Trinity Health compliance policies