Revenue Integrity Account Specialist
trinity
Employment Type:Full timeShift:Day ShiftDescription:Revenue Integrity Account Specialist - Fully RemoteWhy 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.About the job:The Revenue Account Specialist performs analysis of patient clinical and billing data to identify documentation, coding and charging opportunities. Works pre-bill edits and collaborations with intra-departmental team members to identify root cause. 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 or all services provided. Completes assigned reports timely and accurately. What we offer: NO mandatory overtime Benefits first day of employment (including: medical, dental, vision, PTO, life, STD/LTD) Daily Pay Retirement savings account with employer match Generous paid time off programs Employee referral incentive programTuition/professional development reimbursementNursing Scholarship opportunitiesState of the art equipmentSupportive team approachRequirements:Education: Most 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 bachelors degree in healthcare or Business administration, Finance, Accounting, Nursing, or a related field, or an equivalent combination of years of education and experience.Licensure: RHIA, RHIT, CCS, CPC/COC or other coding credentials strongly preferred. CDC (healthcare compliance Certification) preferredExperience: 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.Experience: Two to three years' experience in charge entry and coding in the medical office setting is preferred. Must have a working knowledge of CPT, ICD-10 and HCPCS coding guidelines. Advanced knowledge of the registration process and insurance requirements.Other Job Requirements: proficiency with MS Excel, Access, Business Objects highly desired, and strong level competency with Word and PowerPoint. Must possess a demonstrated knowledge of clinical processes; charge master maintenance, clinical coding (CPT, HCPCS, ICD-9/10, revenue codes and modifiers)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 Discharge Note Final Billed (DNFB)Our system includes:
• 254-bed acute-care hospital at the Mishawaka Medical Center
• 58-bed acute-care hospital at the Plymouth Medical Center
• More than 85 providers in the Saint Joseph Physician Network
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.About the job:The Revenue Account Specialist performs analysis of patient clinical and billing data to identify documentation, coding and charging opportunities. Works pre-bill edits and collaborations with intra-departmental team members to identify root cause. 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 or all services provided. Completes assigned reports timely and accurately. What we offer: NO mandatory overtime Benefits first day of employment (including: medical, dental, vision, PTO, life, STD/LTD) Daily Pay Retirement savings account with employer match Generous paid time off programs Employee referral incentive programTuition/professional development reimbursementNursing Scholarship opportunitiesState of the art equipmentSupportive team approachRequirements:Education: Most 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 bachelors degree in healthcare or Business administration, Finance, Accounting, Nursing, or a related field, or an equivalent combination of years of education and experience.Licensure: RHIA, RHIT, CCS, CPC/COC or other coding credentials strongly preferred. CDC (healthcare compliance Certification) preferredExperience: 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.Experience: Two to three years' experience in charge entry and coding in the medical office setting is preferred. Must have a working knowledge of CPT, ICD-10 and HCPCS coding guidelines. Advanced knowledge of the registration process and insurance requirements.Other Job Requirements: proficiency with MS Excel, Access, Business Objects highly desired, and strong level competency with Word and PowerPoint. Must possess a demonstrated knowledge of clinical processes; charge master maintenance, clinical coding (CPT, HCPCS, ICD-9/10, revenue codes and modifiers)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 Discharge Note Final Billed (DNFB)Our system includes:
• 254-bed acute-care hospital at the Mishawaka Medical Center
• 58-bed acute-care hospital at the Plymouth Medical Center
• More than 85 providers in the Saint Joseph Physician Network
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.
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