Revenue Integrity Recovery Coordinator

4 weeks ago

Silver Spring, Maryland, United States Trinity Health Full time
Employment Type:Full timeShift:Day ShiftDescription:use previous description.

Job Title:

Revenue Integrity Recovery Coordinator

Employment Type:

Full-Time

Shift:

Days

(SUMMARY) Position Highlights:

  • Competitive pay
  • Additional Benefits: tuition reimbursement, free parking, employee discounts
  • Quality of Life:Flexible work schedules
  • Advancement:professional growth within the organization
  • Location:Holy Cross Health has two hospitals and four healthcare centers all a short driving distance from Washington DC and Baltimore, MD.

Description:

  • Monday-Friday
  • Works closely with clinical areas to effectively document services performed and understand relationship of documentation, medical necessity, coding and charging for all services provided. Completes assigned reports timely and accurately.

Responsibilities:

  • Responsible for performing 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.
  • Responsible for working complex denial coordination with intra-team members to identify root cause.
  • Performs audits and collaborates with intra and inter-departmental teams on compliance, education, accuracy in charge capture and improvement in the revenue cycle processes as identified through revenue cycle audits and root cause analysis.
  • May be required to travel between locations within the Region.
  • Other duties as assigned by the department Manager

What you will need:

  • Five (5) or more years of experience in billing, charge documentation, charge audit or charge capture activities, or other functions related to revenue cycle activities.
  • 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 as normally obtained through a Bachelor's degree in Healthcare or Business Administration, Finance, Accounting, Nursing, or a related field, or an equivalent combination of years of education and experience.
  • Proficiency with MS Excel, Access, Business Objects highly desired, and strong level of competency with Word and PowerPoint.
  • 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) preferred.
  • Must possess a demonstrated knowledge of clinical processes; charge master maintenance, clinical coding (CPT, HCPCS, ICD-9/10, revenue codes and modifiers), charging processes and audits, and clinical billing.
  • Knowledge of Ambulatory Payment Classification (APC), and Outpatient Prospective Payment System (OPPS) reimbursement structures and prebill edits including Outpatient Coding Edits (OCE)/Correct Coding Initiative (CCI) edits and Discharged Note Final Billed (DNFB).
  • Experience with post payment audits and with coding, clinical and technical denials is required.
  • Exceptional organizational skills and ability to prioritize and manage multiple functions and responsibilities simultaneously.
  • Excellent interpersonal, verbal and written communication and organizational abilities. Accuracy, strong analytical skills, attentiveness to detail and time management skills are required.
  • Must be comfortable operating in a collaborative, shared leadership environment
  • Must possess a personal presence that is characterized by a sense of honesty, integrity, and caring with the ability to inspire and motivate others to promote the philosophy, mission, vision, goals, and values of Trinity Health.

About us:

Holy Cross Health is a Catholic, not-for-profit health system that serves more than 240,000 individuals each year from Maryland's two largest counties — Montgomery and Prince George's counties. Holy Cross Health earns numerous national awards, clinical designations and accreditations across a wide range of specialties for providing innovative, high-quality health care services. We were named one of America's 100 Best Hospitals for 2021.

Holy Cross Health is an Equal Employment Opportunity (EEO) employer. Qualified applicants are considered for employment without regard to Minority/Females/disabled/Veteran (M/F/D/V) status

Our Commitment to Diversity and Inclusion

Trinity Health is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians across 25 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions.

Our dedication to diversity includes a unified workforce (through training and education, recruitment, retention, and development), commitment and accountability, communication, community partnerships, and supplier diversity.

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