Revenue Integrity Account Specialist - Remote

Employment Type:

Shift:

Description:

Trinity Health of New England has an exciting opportunity to join our team as a Revenue Integrity Account Specialist

The Revenue Integrity Account Specialist is responsible for performing analysis of patient clinical and billing data to identify documentation, coding and charging opportunities. Works pre-bill edits and collaborates with intra-departmental team members to identify root cause.

What will you do: 

• Assists with 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.
• Performs other revenue optimization activities as appropriate and may assist centralized charge control team when necessary. 
• Maintains an understanding of regulatory and payer changes to ensure correct charging and billing requirements are met.  
• Works with Patient Business Service (PBS) center on requests to or from PBS as needed for payer requests and/or claim adjudication.  

Requirements:

• Bachelor's or Associate degree in healthcare or business administration, Finance, Accounting, Nursing, or a related field
• Three (3) or more years of experience in billing, charge documentation, charge audit or charge capture activities, or other functions related to revenue cycle activities.
• Licensure/Certification:  RHIA, RHIT, CCS, CPC/COC, AAPC or other coding credentials and/or Licensed Vocational Nurse/ Licensed Practical Nurse strongly preferred.  CDC (Healthcare Compliance Certification) preferred. CHRI certification/membership strongly preferred. 
• 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
• Working knowledge of third-party payer rules and requirements, computer operations and electronic interfaces related to charge documentation, capture and billing is required.  
• 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). 

Highlights

• Remote Full Time: Monday - Friday
• Become a valued member of an excellent, dedicated health care team.
• Engaged leadership.
• Excellent Benefits effective on 1st Day

Trinity Health Of New England is an integrated health care delivery system comprised of world-class providers and facilities dedicated to the full spectrum of preventive, acute, and post-acute care, all delivered with the triple aim of better health, better care, and lower costs for our patient populations.

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.