Change Analyst, Revenue Integrity

This is a fully remote position, open to applicants in Michigan.

📋 Description

• Conduct research, gather, and analyze information to pinpoint opportunities, formulate solutions, and guide through resolution.

• Collaborate on initiatives aimed at enhancing program efficiency and improving patient experiences.

• Distribute analytical reports effectively.

• Utilize various system applications to carry out analyses, generate reports, and create educational materials.

• Research and compile data for ad-hoc operational projects and initiatives.

• Synthesize and analyze data, delivering detailed summaries with graphical representations of trends and actionable recommendations.

• Utilize program and operational data to define and showcase progress, return on investment (ROI), and impacts.

• Ensure accurate CPT and/or ICD-10 documentation for patient billing while educating colleagues and providers on precise documentation and coding practices.

• Maintain documentation for the charge capture process and review adherence to processes for missing charges.

• Coordinate with stakeholders regarding system change requests and process enhancements.

• Oversee charge reconciliation processes, including daily and monthly reconciliations.

• Assist clinical departments with reconciliation processes, supply charge capture, duplicate charge identification, and resolution of documentation or charge discrepancies.

• Execute charge entry/capture, grant charge approvals, and conduct quality charge reviews, including appending modifiers and verifying clinical documentation.

• Review and address quality reports that highlight missing, duplicate, and late charges.

• Maintain reference logs and reporting tools; create and present decision-support information.

• Aid in denial-related charge reviews through clinical documentation analysis, root cause analysis, and educational efforts.

⛳️ Requirements

• High school diploma or GED required.

• At least one (1) to two (2) years of relevant experience in a hospital and/or Physician Practice setting.

• Background in revenue cycle management, billing, coding, and/or patient financial services.

• Familiarity with current medical terminology, data entry, supply chain processes, and operations in hospital and/or Medical Group practice.

• Experience with front-end functions of the revenue cycle in hospital and/or Physician group practice, such as patient registration, which may affect charge-related errors.

• Knowledge of billing and regulatory guidelines associated with charging and other revenue cycle processes.

• Capacity to assist clinical departments and/or physician practices in modifying their charging practices according to guidelines.

• Working knowledge of applicable federal, state, and local laws/regulations, as well as the Trinity Health Integrity & Compliance Program and Code of Conduct.

• Preferred certifications include RHIA, RHIT, CCS, CPC/COC, AAPC, or other coding credentials, as well as Licensed Vocational Nurse/Licensed Practical Nurse licensure.

• CHC (Healthcare Compliance Certification) is preferred.

• Strong preference for CHRI certification/membership.

🏝️ Benefits

• Comprehensive health insurance options.

• Generous paid time off policy.

• Opportunities for professional development and career advancement.

• Retirement savings plan with employer match.

• Employee wellness programs and resources.