[Hiring] Senior Clinical Revenue Specialist @TriHealth

Role Description

Join TriHealth as a Sr. Clinical Revenue Specialist! You'll play a critical role behind the scenes, ensuring accurate revenue capture and supporting the financial strength that allows us to deliver exceptional care to the communities we serve. Join a collaborative, mission-driven team where your clinical expertise, analytical skills, and innovative thinking directly impact both patient care and organizational success.

This position provides leadership to identify and implement hospital revenue enhancement opportunities. Consistent evaluation and understanding of changing third-party payer regulations is required to support accurate and compliant gross revenue capture for assigned service lines and hospital locations.

• Provides leadership to identify and implement hospital revenue enhancement opportunities.
• Acts as a liaison, consultant and educator for hospital charge capture to leadership, clinical teams, charge entry team members, IT, billing, and purchasing.
• Maintains accurate and compliant CDM.
• Regularly reviews vendor CDM data scrubber's compliance reports for assigned service areas and hospital locations and takes necessary action to maximize compliant billing and reimbursement.
• Collaborates with leadership and clinical teams on annual strategic pricing to meet gross revenue targets.
• Actively develops with IS liaison, specific Revenue Integrity revenue guardian checks, claim edits, and work queue rules.
• Facilitates development, implementation and provide monitoring of operational charge capture processes that meet regulatory compliance and that are effective for end-users.

Qualifications

• Bachelor's Degree (Required)
• 2 - 3 years experience licensed clinical professional (Required)
• Working knowledge and understanding of HCPCS, CPT, Revenue codes, Budget development and RVUs
• Working knowledge and understanding of EPIC EMR navigation and clinical documentation
• Other Licensed Clinical Professional Upon Hire Preferred
• Other Coding Credentials Upon Hire Preferred

Requirements

• Must reside in Cincinnati-Dayton, Ohio, Northern Kentucky or Eastern Indiana to be considered.
• Full-Time (80 hours bi-weekly)
• Day Shift
• No Weekend, Holiday or On Call Commitment

Benefits

• Comprehensive benefits package including medical, dental, vision, paid time off, retirement plans, and tuition reimbursement.
• Please view our benefits page here .

Working Conditions

• Bending - Rarely
• Climbing - Rarely
• Concentrating - Continuous
• Continuous Learning - Consistently
• Hearing: Conversation - Consistently
• Hearing: Other Sounds - Frequently
• Interpersonal Communication - Consistently
• Kneeling - Rarely
• Lifting <10 Lbs. - Rarely
• Lifting 50+ Lbs. - Rarely
• Lifting <50 Lbs. - Occasionally
• Pulling - Rarely
• Pushing - Rarely
• Reaching - Rarely
• Reading - Consistently
• Sitting - Frequently
• Standing - Rarely
• Stooping - Rarely
• Talking - Consistently
• Thinking/Reasoning - Consistently
• Use of Hands - Frequently
• Color Vision - Occasionally
• Visual Acuity: Far - Frequently
• Visual Acuity: Near - Consistently
• Walking - Frequently

TriHealth SERVE Standards and ALWAYS Behaviors

• Serve: ALWAYS... Welcome everyone by making eye contact, greeting with a smile, and saying "hello".
• Acknowledge when patients/guests are lost and escort them to their destination or find someone who can assist.
• Refrain from using cell phones for personal reasons in public spaces or patient care areas.
• Excel: ALWAYS... Recognize and take personal responsibility to address and recover from service breakdowns when a customer's expectations have not been met.
• Offer patients and guests priority when waiting (lines, elevators).
• Work on improving quality, safety, and service.
• Respect: ALWAYS... Respect cultural and spiritual differences and honor individual preferences.
• Respect everyone's opinion and contribution, regardless of title/role.
• Speak positively about my team members and other departments in front of patients and guests.
• Value: ALWAYS... Value the time of others by striving to be on time, prepared and actively participating.
• Pick up trash, ensuring the physical environment is clean and safe.
• Be a good steward of our resources, using supplies and equipment efficiently and effectively, and will look for ways to avoid waste.
• Engage: ALWAYS... Acknowledge wins and frequently thank team members and others for contributions.
• Show courtesy and compassion with customers, team members and the community.