Remote Revenue Protection Specialist

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.

This role focuses on researching, collecting, and analyzing information to identify opportunities, develop solutions, and lead through resolution. You will collaborate on performance improvement activities, distribute analytical reports, and utilize multiple system applications to perform analysis, create reports, and develop educational materials.

Responsibilities

• Researches, collects, and analyzes information to support operational projects and initiatives.
• Synthesizes and analyzes data, providing detailed summaries, graphical presentations, and practical recommendations while considering business strategy impacts.
• Leverages program and operational data to define and demonstrate progress, ROI, and impacts.
• Develops, monitors, inspects, and proposes measures to improve hospital registration performance.
• Tracks and reports trends to remediate issues and assist with preventive actions for ongoing internal process improvement.
• Conducts facility analysis of denials, prepares review findings, makes recommendations, and collaborates with interdepartmental leaders to implement solutions.
• Facilitates cross-departmental collaboration with clinical departments, Patient Business Service (PBS) center, Payer Strategies, Compliance, and other revenue cycle departments to drive strategic denial initiatives.
• Maintains an understanding of regulatory and payer changes to ensure correct charging and billing requirements are met.

Requirements

• High school diploma.
• Three (3) years of revenue cycle experience (e.g., Billing, Coding, Prior Authorization, Revenue Integrity, collections).
• Knowledge of insurance and governmental programs, regulations, and billing processes (e.g., Medicare, Medicaid, managed care contracts, coordination of benefits).

Qualifications

• Certification and membership in AAPC, AHIMA, HFMA, AAHAM, or NAHAM strongly preferred.
• Bachelor’s degree in a related field (preferred).
• Understanding of Revenue Cycle Key Performance Indicators and ability to identify vulnerabilities related to quality performance.
• Working knowledge of denials-related software technology (strongly preferred).
• Experience in non-acute care revenue cycle (a plus for Physician Billing Denials Prevention).

Pay

Compensation range: $24.5303 - $36.7954 per hour.