Coordinator – Revenue Integrity

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

📋 Description

• Oversee and assist with workflow and departmental operations.

• Coordinate technical, operational, and clerical support services.

• Organize and prioritize workflows based on customer requirements.

• May supervise a small team and act as a mentor.

• Develop and uphold procedural standards and documentation.

• Create and sustain educational programs for the team, including orientation for new employees.

• Utilize various systems for data management and collection.

• Collaborate on initiatives for performance enhancement and assist in identifying and resolving operational challenges.

• Clearly communicate goals, standards, program expectations, service performance, and objectives of Trinity Health.

• Identify, address, and escalate conflicts within the organization, operations, and team dynamics.

• Ensure compliance with relevant laws, regulations, and the policies and procedures of Trinity Health.

• Guarantee accurate CPT/HCPCS documentation for patient billing.

• Provide training for colleagues and ancillary departments on proper documentation and coding practices.

• Conduct charge capture in designated Revenue Integrity areas.

• Review clinical documentation and charts to interpret, validate, and extract charges.

• Confirm charges are associated with the correct patient, encounter, date of service, and necessary modifiers.

• Abstract data to ensure alignment of charges and coding with AMA and Medicare guidelines.

• Conduct CPT and ICD-10 coding, review documentation, and manage claim denials.

• Address pre-bill edits including OCE/CCI and DNFB while adhering to key metrics.

• Offer on-site support to ancillary departments, detect duplicate or missing charges, and initiate communication to rectify discrepancies.

• Execute charge entry, approvals, and quality reviews, including checks for modifiers and clinical documentation.

• Provide constructive feedback to colleagues in Revenue Integrity.

• Code and/or validate charges for intricate service lines and advanced surgical or specialty coding.

• Educate clinical personnel on accurate and comprehensive documentation to optimize revenue and maintain integrity.

⛳️ Requirements

• Associate’s degree in healthcare, business administration, finance, accounting, or a related field, or equivalent experience considered in place of a degree.

• At least three (3) years of relevant experience in coding and charge control within a hospital and/or Physician Practice setting.

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

• Proven understanding of clinical processes, charge master management, clinical coding (CPT, ICD-10, revenue codes & modifiers), charging processes & audits, and clinical billing.

• Familiarity with third-party payer regulations and requirements, computer operations, and electronic systems related to charge documentation and billing.

• Insight into charge capture, reconciliation, error management, and overall revenue cycle operations.

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

• CHC certification is preferred.

• Strong preference for CHRI certification/membership.

• Registered Nurse designation is highly preferred.

• Understanding of APC, OPPS reimbursement structures, OCE/CCI edits, and DNFB.

• Strong preference for knowledge of clinical documentation improvement processes.

🏝️ Benefits

• Remote work option available.

• Day shift schedule.

• Commitment to being an Equal Opportunity Employer.