Revenue Integrity Coding Specialist

Trinity Health; United States; Remote; USD 70,000 - 95,000; Full time

Benefits offered by this job

Tuition reimbursement for employees

Benefits day one (Medical, Dental, PTO

Employer retirement match

7 holidays

Job summary

Saint Joseph Health System is seeking a billing and denial prevention analyst to perform in-depth analysis of patient clinical and billing data, identify documentation and coding gaps, and develop action plans for denial prevention. The role requires coordination with intra-team members to improve revenue cycle efficiency and compliance with billing guidelines.

Responsibilities include audits, collaboration with clinical areas to document services, and supporting education for accurate charge

Qualifications

• 5+ years billing experience or related revenue cycle functions.
• Experience with denial prevention and root-cause analysis.
• Knowledge of physician practice coding and charge capture processes.

Responsibilities

• Perform in-depth analysis of patient clinical and billing data to identify documentation, coding and denial prevention.
• Develop and implement action plans for denial prevention based on root cause findings.
• Collaborate with intra- and inter-departmental teams on compliance and accuracy in charge capture.

Skills

5+ years billing experience

Denials management

Root cause analysis

Coding knowledge (CPT/ ICD-10)

Education

Bachelor's degree in Healthcare Administration or Business

Tools

CPT, ICD-10, revenue codes & modifiers

Job description

Employment Type: Full time Shift: Day Shift Description: Location: 100% Remote Status: Full Time- 40 hours Flexible Schedule

Responsible for Urology, Hematology Oncology, and Wellness and Weight Management practices.

Saint Joseph Health System is proud to offer Daily Pay. Work Today, Get Paid Today!

Why Saint Joseph Health System?

At Saint Joseph Health System, our values give us strength. That character guides every decision we make - even when those decisions are complicated, costly or hard. We honor our mission to care for every man, woman and child who needs us by investing in technology, people and capabilities that allow us to set the standard for quality care.

What we offer:

• Tuition reimbursement for all full and part-time colleagues effective first day of employment
• 100% paid tuition for ASN to BSN program (paid directly to learning partner)
• Benefits day one (Including: Medical, Dental, Vision, PTO, Life, STD/LTD, etc.)
• Retirement savings account with employer match
• Generous paid time off program + 7 paid holidaysNO mandatory overtime
• Employee referral incentive program
• State of the art equipment, unlimited CEU's and supportive team approach

JOB SUMMARY

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.

JOB SPECIFICATIONS AND CORE COMPETENCIES

Education: 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.

Experience: 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 be knowledgeable in physician practice coding.

Our Commitment

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. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.