Revenue Integrity Recovery Coordinator

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

📋 Description

• Conduct thorough analyses of patient clinical and billing data to uncover opportunities for improving documentation, coding, and preventing denials.

• Create and execute action plans aimed at preventing denials, grounded in root-cause analysis.

• Collaborate with intra-team members to coordinate complex denial cases and identify underlying causes.

• Examine data to report trends, performance metrics, process enhancements, and financial impacts.

• Offer education, facilitate process improvements, and continuously assess and resolve root-cause issues.

• Execute departmental audits to ensure compliance with state and federal guidelines regarding documentation and billing practices.

• Compile and present audit findings, offer recommendations, and implement solutions in partnership with revenue integrity and inter-departmental leaders.

• Partner with clinical departments, Patient Business Service, Payer Strategies, Compliance, and other revenue cycle units to manage denial prevention and coordination.

• Assist with system implementations, upgrades, and new service-line requests to maintain revenue cycle integrity and compliance.

• Establish processes with ancillary teams and providers to mitigate future denials.

• Monitor potential risk accounts and review them with Finance to assess impacts on reserves and the Bad Debt Charity Operational write-offs model.

• Accurately complete assigned reports in a timely manner.

• May support the centralized charge control team and travel between various locations within the region.

⛳️ Requirements

• Bachelor's degree in Healthcare or Business Administration, Finance, Accounting, Nursing, or a related discipline, or an equivalent combination of education and experience.

• Minimum of five (5) years of experience in billing, charge documentation, charge auditing, charge capture, or similar revenue cycle roles.

• Proven expertise in clinical processes, charge master maintenance, clinical coding (CPT, HCPCS, ICD-9/10, revenue codes, and modifiers), charging processes and audits, as well as clinical billing.

• Proficiency in MS Excel, Access, and Business Objects is highly preferred.

• Strong skills in Word and PowerPoint.

• Familiarity with third-party payer rules and requirements, computer operations, and electronic interfaces relevant to charge documentation, capture, and billing.

• Understanding of Ambulatory Payment Classification (APC), Outpatient Prospective Payment System (OPPS), prebill edits, OCE/CCI edits, and DNFB.

• Required experience with post-payment audits and coding, as well as clinical and technical denials.

• Preferred credentials include RHIA, RHIT, CCS, CPC/COC, or other coding certifications.

• CDC (Healthcare Compliance Certification) and CHRI are also preferred.

• Exceptional skills in organization, analysis, interpersonal communication, both verbal and written.

• Capability to prioritize and manage several functions and responsibilities simultaneously.

• Strong attention to detail, accuracy in work, and effective time-management skills.

• Ability to collaborate effectively in a shared-leadership environment.

• Must embody honesty, integrity, compassion, and the ability to promote Trinity Health's mission, vision, goals, and values.

🏝️ Benefits

• Comprehensive benefits packages, including medical, dental, vision, mental health, paid time off, 403B, education assistance, and voluntary benefits (such as pet insurance, accident insurance, hospital indemnity, and more) available from the first day of employment.

• Work/life balance with flexible scheduling options.

• Complimentary onsite parking.

• Referral Rewards Program.