Specialist Charge, Coder Revenue Integrity

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

📋 Description

• Conduct research, gather, analyze, synthesize, and summarize both operational and clinical data.

• Generate and disseminate analytical reports featuring graphical representations of trends.

• Propose practical alternatives and solutions to facilitate leadership decision-making.

• Recognize opportunities for process enhancements and lead initiatives to resolution.

• Collaborate on performance enhancement activities aimed at improving program efficiency and patient experience.

• Utilize various system applications to conduct analysis, generate reports, and create educational materials.

• Investigate and gather information for ad-hoc operational projects and initiatives.

• Define and illustrate progress, ROI, and operational impacts using program data and metrics.

• Ensure precise CPT and/or ICD-10 documentation for patient billing purposes.

• Educate team members and providers on accurate service documentation and correct coding practices.

• Maintain comprehensive documentation concerning charge capture processes.

• Review adherence to processes and identify any missing charges.

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

• Oversee charge reconciliation for assigned departments, including daily and monthly reconciliations.

• Execute charge entry/capture, charge approvals, quality charge reviews, modifier appending, and clinical documentation checks.

• Provide insights to Revenue Integrity colleagues on potential improvement opportunities.

• Assist with denial-related charge reviews, clinical documentation analysis, root cause analysis, and education.

• Conduct daily reconciliations and offer on-site support to ancillary departments.

• Verify supply and implant charges, identify duplicate charges, and communicate documentation or charge deficiencies and errors.

⛳️ Requirements

• High school diploma or GED is required.

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

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

• Familiarity with current clinical processes, charge master maintenance, clinical coding guidelines, charging processes and audits, and clinical billing.

• Strong working knowledge of medical terminology, data entry, supply chain processes, and hospital and/or Medical Group practice operations.

• Experience with Ambulatory Payment Classification (APC), Outpatient Prospective Payment System (OPPS), Outpatient Coding Edits (OCE), Correct Coding Initiative (CCI) edits, and Discharged Note Final Billed (DNFB).

• Capability to perform charge capture processes and investigate charge errors effectively.

• Experience with revenue cycle functions on both front-end and back-end in hospital and/or Physician group practices.

• RHIA, RHIT, CCS, CPC/COC or other coding credentials and/or Licensed Vocational Nurse/Licensed Practical Nurse licensure is mandatory.

• Epic experience is preferred.

• CHC (Healthcare Compliance Certification) is a plus.

• CHRI certification/membership is strongly preferred.

• Knowledge of clinical documentation improvement processes is highly favored.

• Ability to adhere to relevant laws, regulations, Trinity Health policies, procedures, guidelines, and the Code of Conduct.

• Proficiency in using computers and other technological tools.

• Capability to lift a maximum of 30 pounds unassisted occasionally.

• Ability to provide assistance during emergencies.

🏝️ Benefits

• Remote work position available.

• Equal Opportunity Employer.