[Hiring] Charge Revenue Integrity Analyst @Trinity Health

Role Description

Responsible for the data capture, analysis & reporting of data information to assist the Trinity Health leadership team achieve operational efficiency. Responsible for auditing of department information, producing reports & suggesting improvements to processes. Provides knowledge & expertise in the program, services & applications.

Essential Functions:

• Knows, understands, incorporates & demonstrates our Trinity Health Mission, Values, Vision, Actions & Promise in behaviors, practices & decisions.
• Researches, collects & analyzes information.
• Identifies opportunities, develops solutions, & leads through resolution.
• Collaborates on performance improvement activities as indicated by outcomes in program efficiency & patient experience.
• Responsible for distribution of analytical reports.

Process Focus:

• Utilizes multiple system applications to perform analysis, create reports & develop educational materials.
• Incorporates basic knowledge of Trinity Health policies, practices & processes to ensure quality, confidentiality & safety are prioritized.
• Demonstrates knowledge of departmental processes & procedures & ability to readily acquire new knowledge.

Data Management & Analysis:

• Research & compiles information to support ad-hoc operational projects & initiatives.
• Synthesizes & analyzes data & provides detailed summaries including graphical data presentations illustrating trends & recommending practical options or solutions while considering the impact on business strategy & supporting leadership decision making.
• Leverages program & operational data & measurements to define & demonstrate progress, ROI & impacts.
• Maintains a working knowledge of applicable federal, state & local laws/regulations, Trinity Health Integrity & Compliance Program & Code of Conduct, as well as other policies, procedures & guidelines in order to ensure adherence in a manner that reflects honest, ethical & professional behavior & safe work practices.

Functional Role:

• Responsible for ensuring accurate CPT and/or ICD-10 documentation for the patient billing process and educating colleagues and providers in accurately documenting services performed and using the appropriate codes representing those services.
• Maintains documentation regarding charge capture processes.
• Performs regular reviews of process adherence and identifies missing charges.
• Coordinates with key stakeholders regarding impacts of system change requests and upgrades to processes to ensure capture accuracy.
• Provides oversight of charge reconciliation processes for assigned departments; ensuring daily and appropriate monthly reconciliations are occurring.
• May perform or provide “at elbow” guidance to clinical departmental daily reconciliation processes including ensuring supply charges are appropriately captured (may include implants), identify duplicate charges and initiate appropriate communications when there are documentation and/or charge deficiencies or charge errors.
• Performs charge entry/capture functions, charge approvals, and/or quality charge reviews; including but not limited to, appending modifiers, and checking clinical documentation.
• Provides feedback to intra-departmental Revenue Integrity colleagues including areas of opportunity.
• Reviews and responds to various quality reports, including reports that identify missing charges, duplicate charges, late charges, etc.
• Maintains and updates required reference logs and other reporting tools.
• May create and present information for decision making purposes.
• Supports other stakeholders with denial related charge reviews including analysis of clinical documentation, root cause analysis and education to the responsible ancillary department.

Qualifications

• High school diploma or GED.
• Minimum of one (1) to two (2) years of relevant work experience in a hospital and/or Physician Practice environment and experience in revenue cycle, billing, coding and/or patient financial services. Charge control/capture work experience strongly preferred.
• Experience working with current medical terminology, data entry, supply chain processes, hospital and/or Medical Group practice operations; hospital and/or Physician group practice revenue cycle front-end functions such as patient registration that may impact charge related errors; and billing and regulatory guidelines related to charging and other revenue cycle processes and ability to assist clinical departments and/or physician practices with changes to their charging practices based on guidelines.

Requirements

• Licensure/Certification: RHIA, RHIT, CCS, CPC/COC, AAPC or other coding credentials and/or Licensed Vocational Nurse/Licensed Practical Nurse licensure preferred.
• CHC (Healthcare Compliance Certification) preferred.
• CHRI certification/membership strongly preferred.

Physical & Mental Requirements & Working Conditions

• Exposure to conditions which may be considered unpleasant to sight, touch, sound & / or smell.
• Occasional exposure to fumes, odors, dusts, mists & gases, biohazards / hazards (mechanical, electrical, burns, chemicals, radiation, sharp objects, etc.).
• Occasional exposure to or subject to noise, infectious waste, diseases & conditions.
• Frequent exposure to interruptions, shifting priorities & stressful situations.
• Frequent ability to follow tasks through to completion, understand & relate to complex ideas / concepts, remember multiple tasks & regimens over long periods of time & work on concurrent tasks / projects.
• Frequent ability to read small print, hear sounds & voice / speech patterns, give / receive instructions & other verbal communications (in-person & / or over the phone / computer / device / equipment assigned) with some background noise.
• Continuous performance of manual dexterity activities & / or grasping / handling.
• Occasional ability to climb, kneel, crouch & / or operate foot controls.
• Frequent use of a computer / other technology.
• Frequent ability to sit with the ability to vary / adjust physical position or activity.
• Continuous maintenance of a safe working environment & use of available personal protective equipment (PPE).
• Continuous compliance with Trinity Health’s Code of Conduct, policies, procedures & guidelines.
• Occasional ability to provide assistance in the event of an emergency.

Our Commitment

Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.