REMOTE Revenue Protection Specialist

Trinity Health • Livonia, MI

8d • Remote

About The Position

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

• 3 years revenue cycle, non-acute care.
• 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.

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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED