Analyst Charge Revenue Integrity (Remote)

This is a full-time, remote position with a day shift. The role requires working a rotational weekend approximately every 6 weeks.

About the Role

Responsible for the data capture, analysis, and reporting of data information to assist the Trinity Health leadership team in achieving operational efficiency. This includes auditing department information, producing reports, and suggesting process improvements. Provides expertise in programs, services, and applications.

Responsibilities

• Researches, collects, and analyzes information to identify opportunities, develop solutions, and lead through resolution.
• Collaborates on performance improvement activities to enhance program efficiency and patient experience.
• Distributes analytical reports and utilizes multiple system applications to perform analysis, create reports, and develop educational materials.
• Ensures knowledge of Trinity Health policies, practices, and processes to prioritize quality, confidentiality, and safety.
• Synthesizes and analyzes data, providing detailed summaries with graphical presentations to illustrate trends and recommend solutions.
• Leverages program and operational data to define and demonstrate progress, ROI, and impacts on business strategy.
• Ensures accurate CPT and/or ICD-10 documentation for patient billing and educates colleagues and providers on accurate documentation and coding.
• Maintains documentation regarding charge capture processes and performs regular reviews to identify missing charges.
• Coordinates with key stakeholders on system change requests and upgrades to ensure capture accuracy.
• Provides oversight of charge reconciliation processes for assigned departments, ensuring daily and monthly reconciliations.
• Performs or guides clinical departmental daily reconciliation processes, including supply charge capture, identifying duplicate charges, and initiating communications for charge deficiencies or errors.
• Performs charge entry/capture functions, charge approvals, and quality charge reviews, including appending modifiers and checking clinical documentation.
• Provides feedback to intra-departmental Revenue Integrity colleagues on areas of opportunity.
• Reviews and responds to quality reports identifying missing, duplicate, or late charges.
• Maintains and updates required reference logs and other reporting tools.
• Creates and presents information for decision-making purposes.
• Supports stakeholders with denial-related charge reviews, including clinical documentation analysis, root cause analysis, and education for responsible departments.
• Maintains working knowledge of applicable federal, state, and local laws, Trinity Health’s Integrity & Compliance Program, Code of Conduct, and other policies to ensure adherence.

Requirements

• High school diploma or GED.
• Minimum of one to two years of relevant work experience in a hospital and/or physician practice environment, with experience in revenue cycle, billing, coding, and/or patient financial services.
• Charge control/capture work experience strongly preferred.
• Experience with current medical terminology, data entry, supply chain processes, hospital and/or medical group practice operations, and revenue cycle front-end functions.
• Knowledge of billing and regulatory guidelines related to charging and other revenue cycle processes.
• Ability to assist clinical departments and/or physician practices with changes to charging practices based on guidelines.

Qualifications (Preferred)

• Licensure/Certification: RHIA, RHIT, CCS, CPC/COC, AAPC, or other coding credentials.
• Licensed Vocational Nurse/Licensed Practical Nurse licensure preferred.
• CHC (Healthcare Compliance Certification) preferred.
• CHRI certification/membership strongly preferred.

Physical & Mental Requirements

• Exposure to unpleasant conditions (sight, touch, sound, smell) – Occasional.
• Exposure to fumes, odors, dusts, mists, gases, biohazards, and mechanical/electrical hazards – Occasional.
• Exposure to noise, infectious waste, diseases, and conditions – Occasional.
• Exposure to interruptions, shifting priorities, and stressful situations – Frequent.
• Ability to follow tasks through to completion, understand complex ideas, and work on concurrent tasks – Frequent.
• Ability to read small print, hear sounds, and communicate verbally with some background noise – Frequent.
• Perform manual dexterity activities and grasping/handling – Continuous.
• Climb, kneel, crouch, and operate foot controls – Occasional.
• Use a computer and other technology – Frequent.
• Sit with the ability to vary physical position or activity – Frequent.
• Maintain a safe working environment and use personal protective equipment (PPE) – Continuous.
• Comply with Trinity Health’s Code of Conduct, policies, procedures, and guidelines – Continuous.
• Ability to provide assistance in emergencies – Occasional.
• Perform activities requiring standing/walking and ability to vary physical position – Occasional.
• Lift a maximum of 30 pounds unassisted – Occasional.
• Use upper and lower extremities, engage in bending, stooping, reaching, and pushing/pulling – Occasional.
• Work indoors under temperature-controlled and well-lit conditions – Continuous.
• Encounter worksites with variable environmental conditions – Occasional.
• Perform work involving physical efforts (e.g., transporting, moving, positioning patients) – Occasional.

Pay

Pay range: $21.9481 - $32.9222 per hour.