[Hiring] Revenue Integrity Specialist (Coder) @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 department information, producing reports, & suggesting improvements to processes. Provides knowledge & expertise in the program, services & applications.

• 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.
• Utilizes multiple system applications to perform analysis, create reports & develop educational materials.
• Incorporates basic knowledge of TH policies, practices & processes to ensure quality, confidentiality, & safety are prioritized.
• Demonstrates knowledge of departmental processes & procedures & ability to readily acquire new knowledge.
• 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.
• Maintains a working knowledge of applicable federal, state & local laws / regulations, Trinity Health Integrity & Compliance Program & Code of Conduct.
• Responsible for ensuring accurate CPT and/or ICD-10 documentation for the patient billing process.
• Educates colleagues and providers in accurately documenting services performed.
• 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.
• Provides oversight of charge reconciliation processes for assigned departments.
• Performs charge entry/capture functions, charge approvals, and/or quality charge reviews.
• Provides feedback to intra-departmental Revenue Integrity colleagues.
• Assists Nurse Auditor and/or other stakeholders with denial related charge reviews.
• Performs daily reconciliation processes and/or provides “at-elbow support” to ancillary departments.

Qualifications

• High school diploma or GED.
• 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.
• Experience working with current clinical processes, charge master maintenance, clinical coding guidelines, charging processes and audits.
• Strong working knowledge of medical terminology, data entry, supply chain processes, hospital and/or Medical Group practice operations.
• Experience working with Ambulatory Payment Classification (APC), and Outpatient Prospective Payment System (OPPS) reimbursement structures.
• Ability to perform charge capture processes, including understanding technical integration of electronic medical record.
• Epic experience desired.
• Experience working with Hospital and/or Physician group practice revenue cycle front-end and back-end functions.

Requirements

• Licensure/Certification: RHIA, RHIT, CCS, CPC/COC or other coding credentials.
• Licensed Vocational Nurse/ Licensed Practical Nurse licensure is required.
• CHC (Healthcare Compliance Certification) preferred.
• CHRI certification/membership strongly preferred.
• Knowledge of clinical documentation improvement processes 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.
• Occasional exposure to noise, infectious waste, diseases & conditions.
• Frequent ability to follow tasks through to completion and understand complex ideas/concepts.
• Frequent ability to read small print, hear sounds & voice/speech patterns.
• Continuous 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).
• Occasional ability to provide assistance in the event of an emergency.
• Occasional lifting of a maximum of 30 pounds unassisted.
• Occasional work that involves physical efforts (e.g., transporting, moving, positioning & / or ambulating patients).

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.