Revenue Cycle Integrity Specialist

3 weeks ago

Grand Rapids, Michigan, United States Trinity Health Full time

We are seeking a detail-oriented Revenue Cycle Integrity Specialist to join our team at Trinity Health. This role will be responsible for performing in-depth analysis of patient clinical and billing data to identify documentation, coding, and denial prevention opportunities. The successful candidate will develop and implement action plans for denial prevention based on root cause analysis findings.



Key Responsibilities:

  • Collaborate with intra-departmental teams to investigate denials and identify opportunities for denial prevention along the revenue cycle.
  • Analyze data and reports trends, performance metrics, process improvements, and impact to revenue.
  • Conduct departmental audits to ensure proper documentation and compliance with state and federal guidelines relating to charge capture and billing of services.
  • Collaborate 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.


This is an exciting opportunity for a Clinical Revenue Protection Coordinator to join our team and make a meaningful contribution to the revenue integrity of Trinity Health. We are committed to attracting and retaining top talent who share our values and are passionate about delivering exceptional patient care.



Requirements:

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


As a Denial Prevention and Recovery Expert, you will be responsible for developing and implementing strategies to prevent denials and improve revenue cycle processes. This role requires a strong analytical mindset, excellent communication skills, and the ability to work collaboratively with cross-functional teams.



What We Offer:

  • A competitive salary and benefits package.
  • Ongoing training and development opportunities.
  • A collaborative and supportive work environment.
  • The opportunity to make a meaningful contribution to the revenue integrity of Trinity Health.


We are an Equal Opportunity Employer and welcome applications from diverse candidates. If you are a motivated and detail-oriented individual who is passionate about delivering exceptional patient care, we encourage you to apply for this exciting opportunity.



About Us:

Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. We are committed to integrating 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.

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