Trinity Health
We are one of the largest not-for-profit, faith-based health care systems in the nation.
Revenue Integrity Charge Specialist
Location
United States
Posted
5 days ago
Salary
Not specified
No structured requirement data.
Job Description
Responsible for ensuring accurate CPT and/or ICD-10 documentation for the patient billing process and educating colleagues and providers in accurately documenting services performed and using the appropriate codes representing those services.
Maintains documentation regarding charge capture processes
Performs regular reviews of process adherence and identifies missing charges
Coordinates with key stakeholders regarding impacts of system change requests and upgrades to processes to ensure capture accuracy
Provides oversight of charge reconciliation processes for assigned departments; ensuring daily and appropriate monthly reconciliations are occurring
Performs charge entry, charge approvals, and/or quality charge reviews; including but not limited to, appending modifiers and checking clinical documentation
Provides feedback to intra-departmental Revenue Integrity colleagues including areas of opportunity
Works closely with Providers to educate on improved documentation to support coding
Job Requirements
- High school diploma or equivalent combination of education and experience
- Minimum three (3) years of relevant coding and charge control work experience in a Hospital and/or Physician Practice environment
- Experience in revenue cycle, billing, coding and/or patient financial services
- Strong working knowledge of Medical terminology, data entry, supply chain processes, hospital and/or Medical Group practice operations
- Licensure / Certification: RHIA, RHIT, CCS, CPC/COC or other coding credentials is required
- CHC (Healthcare Compliance Certification) preferred
- AAPC, AHIMA or CCSP certification/membership preferred
- Demonstrated knowledge of clinical processes, clinical coding (CPT, HCPCS, ICD-9/10, revenue codes and modifiers), charging processes and audits, and clinical billing
- Strong understanding of various medical claim formats
- Knowledge of clinical documentation improvement processes strongly preferred
- Strong knowledge of Ambulatory Payment Classification (APC), and Outpatient Prospective Payment System (OPPS) reimbursement structures
- Prior cardiac cath/interventional radiology charging/coding experience strongly preferred
- Ability to perform charge capture processes, including understanding technical integration of electronic medical record and the automation of charge triggers
- Epic experience desired
- Knowledge of Hospital and/or Physician group practice revenue cycle front-end and back-end functions that may impact charge related errors
- Ability to organize and prioritize work in a diverse, fast-paced environment while working on multiple projects simultaneously
- Strong problem-solving skills, analytical abilities, excellent interpersonal, verbal and written communication skills
- Knowledge of billing and regulatory guidelines as related to charging and other revenue cycle processes
- Experience with MS Excel, Word and PowerPoint preferred
- Must be comfortable operating in a collaborative, shared leadership environment
- Maintains a working knowledge of applicable Federal, State, and Local laws and regulations
Benefits
- Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings
- By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care
- We are an Equal Opportunity Employer