Employment Type:

Full time

Shift:

Description:

Revenue Integrity Recovery Liaison (REMOTE)

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. 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. May be required to travel between locations within the Region.

As a mission-driven innovative health organization, we will become the national leader in improving the health of our communities and each person we serve. By demonstrating reverence, commitment to those who are poor, justice, stewardship, and integrity, our organization will continue to provide better health, better care, at lower costs.

Qualifications

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.

5+ years of experience in billing, charge documentation, charge audit or charge capture activities, or other functions related to revenue cycle activities.

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).

Must be able to work in an environment that may be stressful with a variety of individuals having diverse personalities and work styles.

Exceptional organizational skills and ability to prioritize and manage multiple functions and responsibilities simultaneously.

Experience with post payment audits and with coding, clinical and technical denials is required.

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.

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.

Trinity Health MI

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Revenue Integrity Recovery Liaison