**Employment Type:**
Full time
**Shift:**
Day Shift
**Description:**
**Our Trinity Health Culture:** Knows, understands, incorporates & demonstrates our Trinity Health Mission, Values, Vision, Actions & Promise in behaviors, practices & decisions.
**Essential Functions:**
+ Responsible for ensuring accurate CPT/HCPCS documentation for the patient billing process and educating colleagues and ancillary departments in accurately documenting services performed and using the appropriate codes representing those services.
+ Responsible for charge capture in Revenue Integrity assigned areas.
+ Reviews chart, including nursing notes, physician orders, progress notes, and surgical or specialty notes thoroughly to interpret and validate and/or extract all charges.
+ Verifies charges captured on the correct patient, correct encounter, correct date of service, with any required modifiers.
+ Review's documentation, abstracts data and ensure charges/coding are in alignment within AMA and Medicare coding guidelines.
+ Performs coding functions, including CPT, ICD-10 assignment, documentation review and claim denial review
+ Responsible for working the pre-bill edits within key metrics, including but not limited to OCE/CCI, & DNFB.
+ Provides "at-elbow support" to ancillary departments including but not limited to; ensuring supply charges are appropriate captured (may include implants), identify duplicate charges and initiate appropriate communications when there are documentation and/or charge deficiencies or charge errors.
+ Performs charge entry, charge approvals, and/or quality charge reviews; including but not limited to, appending modifiers, and checking clinical documentation.
+ Provides feedback to intra-departmental Revenue Integrity colleagues including areas of opportunity.
+ Responsible for coding and/or validation of charges for more complex service lines, advanced proficiencies in surgical or specialty coding practice.
+ Educates clinical staff on need for accurate and complete documentation to ensure revenue optimization and integrity.
**Communication:**
+ Employs effective & respectful written, verbal & nonverbal communications; Develops an environment of mutual confidence & trust through collaborative relationships;
+ Effectively communicates goals, standards, program expectations, service performance & how the work serves Trinity Health objectives;
+ Proactively recognizes, addresses & / or escalates organizational, operational & / or team conflicts.
**Minimum Qualifications:**
+ Associate's degree in healthcare, business administration, finance, accounting, or related field or equivalent experience considered in lieu of degree.
+ Minimum three (3) years of relevant coding and charge control work experience in a hospital and/or Physician Practice environment and experience in revenue cycle, billing, coding, and/or patient financial services.
+ Must possess a demonstrated knowledge of clinical processes, charge master maintenance, clinical coding (CPT, ICD-10, revenue codes & modifiers), charging processes & audits, & clinical billing
+ Working knowledge of third-party payer rules & requirements, computer operations & electronic interfaces related to charge documentation, capture & billing is required.
+ Knowledge of charge capture, reconciliation, error management operations & overall revenue cycle operations required.
**Additional Qualifications (nice to have):**
+ Licensure/Certification: RHIA, RHIT, CCS, CPC/COC or other coding credentials and/or
+ Licensed Vocational Nurse/ Licensed Practical Nurse licensure is strongly preferred. CHC (Healthcare Compliance Certification) preferred. CHRI certification/membership strongly preferred.
+ Registered Nurse, strongly preferred
+ Licensure/Certification: RHIA, RHIT, CCS, CPC/COC or other coding credentials and/or
+ Licensed Vocational Nurse/ Licensed Practical Nurse licensure is strongly preferred. CHC (Healthcare Compliance Certification) preferred. CHRI certification/membership strongly preferred.
+ Knowledge of Ambulatory Payment Classification (APC), & Outpatient Prospective Payment System (OPPS) reimbursement structures & prebill edits including Outpatient Coding Edits (OCE)/Correct Coding Initiative (CCI) edits & Discharged Note Final Billed (DNFB).
+ Knowledge of clinical documentation improvement processes strongly preferred
**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.
Our Commitment to Diversity and Inclusion
Trinity Health is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians across 25 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions.
Our dedication to diversity includes a unified workforce (through training and education, recruitment, retention, and development), commitment and accountability, communication, community partnerships, and supplier diversity.
EOE including disability/veteran