Revenue Integrity Coding Specialist

Trinity Health•South Bend, IN

2d•Remote

About The Position

The Revenue Integrity Coding Specialist is responsible for revenue integrity support for Urology, Hematology Oncology, and Wellness and Weight Management practices. The role analyzes patient clinical and billing data to identify documentation and coding issues and prevent denials. It develops and implements denial-prevention action plans based on root-cause analysis and supports revenue-cycle efficiency, data integrity, and compliance with billing and regulatory guidelines. The specialist coordinates complex denials with intra-team members to identify root causes, performs audits, and collaborates with clinical and other departments on compliance, education, charge-capture accuracy, and revenue-cycle process improvement. The role works with clinical areas to support accurate documentation of services and understanding of the relationships among documentation, medical necessity, coding, and charging. Assigned reports must be completed accurately and on time. Travel between locations within the Region may be required. This is a full-time, 40-hour-per-week position with a flexible schedule, day shift, and a 100% remote location designation.

Requirements

Demonstrated knowledge of clinical processes, charge master maintenance, clinical coding (CPT, ICD-10, revenue codes, and modifiers), charging processes and audits, and clinical billing, normally obtained through a bachelor's degree in Healthcare or Business Administration, Finance, Accounting, Nursing, or a related field, or an equivalent combination of education and experience.
Five or more years of experience in billing, charge documentation, charge audit or charge capture activities, or other revenue-cycle-related functions.
Knowledge of physician practice coding.

Responsibilities

Perform in-depth analysis of patient clinical and billing data to identify documentation and coding issues and prevent denials.
Develop and implement denial-prevention action plans based on root-cause analysis findings.
Promote revenue-cycle operational efficiency, data integrity, and compliance with billing and regulatory guidelines.
Coordinate complex denials with intra-team members to identify root causes.
Perform audits and collaborate with intra- and inter-departmental teams on compliance, education, charge-capture accuracy, and revenue-cycle process improvement.
Work with clinical areas to support effective documentation of services and understanding of the relationships among documentation, medical necessity, coding, and charges.
Complete assigned reports accurately and on time.
Travel between locations within the Region when required.

Benefits

Daily Pay
Tuition reimbursement for full-time and part-time colleagues, effective on the first day of employment.
100% paid tuition for the ASN-to-BSN program, paid directly to the learning partner.
Benefits beginning on the first day, including medical, dental, vision, paid time off, life insurance, and short- and long-term disability.
Retirement savings account with employer match.
Generous paid time off program and seven paid holidays.
No mandatory overtime.
Employee referral incentive program.
State-of-the-art equipment.
Unlimited continuing education units (CEUs).
Supportive team approach.