Specialist, Charge Revenue Integrity

🔥 0 minutes ago

🚗 Michigan – Remote

🚗 Michigan – Remote

💵 $25 - $37 / 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

• Support organizational areas of expertise using data, research analysis, critical thinking, and problem-solving • Research, collect, and analyze information; identify opportunities; develop solutions; and lead 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 • Research and compile information for ad-hoc operational projects and initiatives • Synthesize and analyze data; provide detailed summaries and graphical presentations illustrating trends and recommending 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 documentation and coding • Perform charge capture in assigned Revenue Integrity areas • Review charts and clinical documentation to interpret, validate, and extract charges • Verify charges are assigned to the correct patient, encounter, date of service, and modifiers • Abstract data and ensure charges/coding align 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 and implant charge capture, duplicate-charge identification, and correction of documentation or charge deficiencies • Perform charge entry, charge approvals, and quality charge reviews, including 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 to optimize revenue 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 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 • CDC certification preferred • CHRI certification/membership strongly preferred • Knowledge of APC and OPPS reimbursement structures and prebill edits including OCE/CCI and DNFB • Knowledge of clinical documentation improvement processes strongly preferred • Ability to follow tasks through to completion and manage concurrent tasks/projects • Ability to read small print, hear sounds and verbal communications, and give/receive instructions • Ability to use a computer and other technology • Ability to maintain a safe working environment and use PPE • Ability to provide assistance in an emergency • Ability to lift a maximum of 30 pounds unassisted • Ability to perform required standing, walking, bending, stooping, reaching, pushing, and pulling • Ability to comply with Trinity Health’s Code of Conduct, policies, procedures, and guidelines

🏖️ Benefits

• Work Remote Position • Day Shift • Equal Opportunity Employer