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Trinity Health's St. Mary Medical Center seeks a Revenue Integrity Recovery Coordinator to analyze patient data, identify documentation, coding and denial prevention opportunities, and implement corrective action plans.
This full-time, day-shift role collaborates across departments to improve accuracy in charge capture and regulatory compliance. Responsibilities include conducting audits, supporting education initiatives, and partnering with clinical areas to ensure proper documentation and
Job Title: Revenue Integrity Recovery Coordinator
Employment Type: Full time
Employment Type: Full-time
Shift: Day
Location: St. Mary's Medical Center
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.
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.
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.
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), CHRI 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.
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.
FT/PT Benefit eligible Roles
**0.5 FTE (20 hours weekly) up to 1.0 FTE (40 hours weekly)**
is a beautiful 53-acrestate-of-the‑artfacilitycomprisedof more than 700 physicians,nearly 3,000colleagues, and 1,100 volunteers committed to providing quality care delivered with compassion and respect.St. Mary attracts top doctors, introducescutting‑edgetechnologiesand implements advanced procedures to meet the healthcare needs of the people it serves, including thenearly630,000residentsof Bucks County.
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.