Revenue Integrity Recovery Coordinator

Employment Type:Full timeShift:Day Shift

Description:

Performs in-depth analysis of patient clinical and billing data to identify documentation, coding and denial prevention. Develops and implements action plans for denial prevention based on root cause analysis findings. Promotes revenue cycle operational efficiency, data integrity and compliance with billing and regulatory guidelines. Works complex denial coordination with intra-team members to identify root cause. Performs audits and collaborates with intra and inter-departmental teams on compliance, education and accuracy in charge capture and improvement in the revenue cycle processes as identified through revenue cycle audits and root cause analysis. Partners with clinical areas to document rendered services and understand its relationship to documentation, medical necessity, coding and charging. Completes assigned reports timely and accurately.

What the Revenue Integrity Recovery Coordinator will need:

• Required: Bachelor's degree in Healthcare or Business Administration, Finance, Accounting, Nursing, or a related field; or an equivalent combination of education and experience. Must possess a demonstrated knowledge of clinical processes, charge master maintenance, clinical coding (CPT, ICD-10, revenue codes and modifiers), charging processes and audits, and clinical billing.
• Required: Five years of experience in billing, charge documentation, charge audit or charge capture activities, or other functions related to revenue cycle activities.
• Strong knowledge of clinical processes, charge master maintenance, clinical coding (CPT, ICD-10, revenue codes and modifiers), charging processes and audits, and clinical billing. Working knowledge of third-party payer rules and requirements, computer operations and electronic interfaces related to charge documentation, capture and billing. Knowledge of post payment audits and coding, clinical and technical denials. Excellent interpersonal, verbal and written communication and organizational skills. Accuracy, strong analytical skills, attentiveness to detail and time management skills.
• Working knowledge of third-party payer rules and requirements, computer operations and electronic interfaces related to charge documentation, capture and billing is required. Licensure / Certification:  RHIA, RHIT, CCS, CPC/COC or other coding credentials strongly preferred. CDC (Healthcare Compliance Certification), CHRI preferred.

What the Revenue Integrity Recovery Coordinator will do:

• Collaborates with intra-departmental team on denial investigations and root cause analysis, including identifying opportunities for denial prevention along the revenue cycle. Analyzes data and reports trends, performance metrics, process improvements and impact to revenue.
• Performs other revenue optimization activities, including providing education, process improvement, ongoing assessment and resolution of root cause issues. May assist centralized charge control team when necessary.
• Conducts departmental audits to ensure proper documentation and compliance with state and federal guidelines relating to the charge capture and billing of services. Prepares and submits audit findings, makes recommendations, and works closely with revenue integrity leadership and inter-departmental leaders to implement solutions.
• Collaborates with clinical departments, Patient Business Service (PBS) center, Payer Strategies, Compliance and other revenue cycle departments on denial coordination, denial prevention and pre-bill edit prevention.
• Works closely with Professional Revenue Site Operations Liaisons and/or Physician operational leaders on system implementations, enhancements and new service line requests to ensure revenue cycle integrity and compliance.
• Works with ancillary teams and Providers to develop processes to minimize future denials.

Our Commitment to Diversity and Inclusion
 

Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law.