REMOTE Revenue Protection Specialist

Employment Type: Full time

About the Role

Our Trinity Health Culture: Knows, understands, incorporates and demonstrates our Trinity Health Mission, Values, Vision, Actions and Promise in behaviors, practices and decisions.

Responsibilities

• Researches, collects and analyzes information.
• Identifies opportunities, develops solutions, and leads through resolution.
• Collaborates on performance improvement activities as indicated by outcomes in program efficiency and patient experience.
• Responsible for distribution of analytical reports.
• Utilizes multiple system applications to perform analysis, create reports and develop educational materials.
• Incorporates basic knowledge of Trinity Health policies, practices and processes to ensure quality, confidentiality, and safety are prioritized.
• Demonstrates knowledge of departmental processes and procedures and ability to readily acquire new knowledge.
• Research and compiles information to support ad-hoc operational projects and initiatives.
• Synthesizes and analyzes data and provides detailed summaries including graphical data presentations illustrating trends and recommending practical options or solutions while considering the impact on business strategy and supporting leadership decision making.
• Leverages program and operational data and measurements to define and demonstrate progress, ROI and impacts.
• Maintains a working knowledge of applicable Federal, state and local laws/regulations, Trinity Health Integrity and Compliance Program and Code of Conduct, as well as other policies, procedures and guidelines to ensure adherence in a manner that reflects safe, honest, ethical and professional behavior and safe work practices.
• Develops, monitors, inspects and 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.

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).

Qualifications (Nice to Have)

• Bachelor’s degree in related field.
• Understands Revenue Cycle Key Performance Indicators and can identify vulnerabilities related to quality performance.
• Working knowledge of denials related software technology.
• Knowledge and experience of Revenue Cycle.
• Three years revenue cycle experience in non-acute care (for Physician Billing Denials Prevention).

Pay

$24.5303 - $36.7954 per hour