Coordinator, Charge Revenue Integrity
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Job Description
Revenue Integrity Coordinator validating hospital charges, coding, and billing documentation for Trinity Health. Supporting ancillary departments and improving charge accuracy across healthcare operations.
Responsibilities:
- Coordinate operational, technical, and/or clerical support services for department processes
- Plan and organize workflows and prioritize customer needs
- May lead a small team and serve as a mentor
- Create and maintain procedural standards and records
- Develop and maintain educational programs, including new employee orientation
- Utilize system applications for data collection and management
- Collaborate on performance improvement activities and lead teams through resolution
- Ensure accurate CPT/HCPCS documentation for patient billing
- Manage charge capture and review charts to interpret, validate, and extract charges
- Verify patient, encounter, date-of-service, and modifier accuracy
- Review documentation and align coding with AMA and Medicare guidelines
- Perform CPT and ICD-10 coding, documentation review, and claim denial review
- Work pre-bill edits including OCE/CCI and DNFB within key metrics
- Provide at-elbow support to ancillary departments for supply charges, duplicate charges, and documentation deficiencies
- Perform charge entry, charge approvals, and quality charge reviews
- Provide feedback to Revenue Integrity colleagues
- Code and/or validate charges for complex service lines and surgical or specialty coding
- Educate clinical staff on accurate and complete documentation for revenue optimization and integrity
Requirements:
- Associate’s degree in healthcare, business administration, finance, accounting, or related field, or equivalent experience in lieu of degree
- Minimum three years of relevant coding and charge control experience in a hospital and/or physician practice environment
- Experience in revenue cycle, billing, coding, and/or patient financial services
- Demonstrated knowledge of clinical processes, charge master maintenance, clinical coding, charging processes, and audits
- Knowledge of CPT, ICD-10, revenue codes, and modifiers
- Working knowledge of third-party payer rules and requirements
- Working knowledge of computer operations and electronic interfaces related to charge documentation, capture, and billing
- Knowledge of charge capture, reconciliation, error management, and revenue cycle operations
- Knowledge of APC and OPPS reimbursement structures and OCE/CCI pre-bill edits strongly preferred
- Knowledge of clinical documentation improvement processes strongly preferred
- Registered Nurse strongly preferred
- Ability to comply with regulatory standards, policies, procedures, guidelines, and Trinity Health’s Code of Conduct
- Ability to use computer and other technology
- Ability to lift a maximum of 30 pounds unassisted occasionally
Benefits:
- Remote work position
- Day shift
- Professional development and leadership growth
- Support for professional growth of team members
- New employee orientation and team educational programs
- Equal Opportunity Employer
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