Remote Revenue Protection Specialist
About The Position
ESSENTIAL FUNCTIONS Our Trinity Health Culture: Knows, understands, incorporates & demonstrates our Trinity Health Mission, Values, Vision, Actions & Promise in behaviors, practices & decisions. Work Focus: Researches, collects & analyzes information. Identifies opportunities, develops solutions, & leads through resolution. Collaborates on performance improvement activities as indicated by outcomes in program efficiency & patient experience. Responsible for distribution of analytical reports. Process Focus: Utilizes multiple system applications to perform analysis, create reports & develop educational materials. Incorporates basic knowledge of TH policies, practices & processes to ensure quality, confidentiality, & safety are prioritized. Demonstrates knowledge of departmental processes & procedures & ability to readily acquire new knowledge. Data Management & Analysis: Research & compiles information to support ad-hoc operational projects & initiatives. Synthesizes & analyzes data & provides detailed summaries including graphical data presentations illustrating trends & recommending practical options or solutions while considering the impact on business strategy & supporting leadership decision making. Leverages program & operational data & measurements to define & demonstrate progress, ROI & impacts. Maintains a working knowledge of applicable Federal, state & local laws/regulations, Trinity Health Integrity & Compliance Program & Code of Conduct, as well as other policies, procedures & guidelines in order to ensure adherence in a manner that reflects safe, honest, ethical & professional behavior & safe work practices. POSITION PURPOSE Hourly pay range: $20.1351 – $30.1699 Remote Work Opportunity FUNCTION ROLES Develops, monitors, inspects & proposes measures to correct and improve hospital registration performance. Tracks and reports trends to remediate issues and assist with preventive actions for ongoing internal process improvement. Leverages patient access and revenue cycle knowledge to ensure continuous quality improvement. Conducts facility analysis of denials. Prepares and submits review findings, makes recommendations, and works closely with interdepartmental leaders to implement solutions. Proactively facilitates cross-departmental collaboration with clinical departments, Patient Business Service (PBS) center, Payer Strategies, Compliance and other revenue cycle departments to continuously drive strategic denial initiatives and resolution around identified revenue enhancement opportunities. Maintains an understanding of regulatory and payer changes. Special note for Physician Billing Denials Prevention – Additional nice to have qualification: 3 years revenue cycle, non-acute care. Maintains an understanding of regulatory and payer changes to assure correct charging and billing requirements are met.
Requirements
- High school diploma.
- Three (3) years of revenue cycle experience.
- Billing, Coding, PA, Revenue Integrity, collections, etc.
- Knowledge of insurance and governmental programs, regulations, and billing processes (e.g., Medicare, Medicaid, managed care contracts and coordination of benefits)
Nice To Haves
- Certification and membership in AAPC, AHIMA, HFMA, AAHAM, NAHAM strongly preferred
- Bachelor’s degree in related field, preferred
- Understands Revenue Cycle Key Performance Indicators and can identify vulnerabilities related to quality performance.
- Working knowledge of denials related software technology strongly preferred.
- Knowledge and experience of Revenue Cycle.
- Special note for Physician Billing Denials Prevention – Additional nice to have qualification: 3 years revenue cycle, non-acute care.
Responsibilities
- Develops, monitors, inspects & proposes measures to correct and improve hospital registration performance.
- Tracks and reports trends to remediate issues and assist with preventive actions for ongoing internal process improvement.
- Leverages patient access and revenue cycle knowledge to ensure continuous quality improvement.
- Conducts facility analysis of denials.
- Prepares and submits review findings, makes recommendations, and works closely with interdepartmental leaders to implement solutions.
- Proactively facilitates cross-departmental collaboration with clinical departments, Patient Business Service (PBS) center, Payer Strategies, Compliance and other revenue cycle departments to continuously drive strategic denial initiatives and resolution around identified revenue enhancement opportunities.
- Maintains an understanding of regulatory and payer changes.
- Maintains an understanding of regulatory and payer changes to assure correct charging and billing requirements are met.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
