SO Specialist Revenue Protection

Trinity Health Corporation • Livonia, MI

50d

About The Position

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. MINIMUM QUALIFICATIONS High school diploma. Three (3) years of revenue cycle experience. Billing, Coding, PA, Revenue Integrity, collections, etc. Certification and membership in AAPC, AHIMA, HFMA, AAHAM, NAHAM strongly preferred Knowledge of insurance and governmental programs, regulations, and billing processes (e.g., Medicare, Medicaid, managed care contracts and coordination of benefits) Additional Qualifications (nice to have) 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. Our Commitment Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are 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, veteran status, or any other status protected by federal, state, or local law.

Requirements

• High school diploma.
• Three (3) years of revenue cycle experience. Billing, Coding, PA, Revenue Integrity, collections, etc.
• Certification and membership in AAPC, AHIMA, HFMA, AAHAM, NAHAM strongly preferred
• Knowledge of insurance and governmental programs, regulations, and billing processes (e.g., Medicare, Medicaid, managed care contracts and coordination of benefits)

Nice To Haves

• 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.
• 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.

What This Job Offers

• Job Type: Full-time
• Industry: Religious, Grantmaking, Civic, Professional, and Similar Organizations
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees