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TriHealth · 1 day ago

Senior Revenue Cycle Specialist

Cincinnati, OH

Full-time

Onsite

Mid, Senior Level

2+ years exp

TriHealth is a healthcare organization committed to serving patients and communities. They are seeking a Senior Revenue Cycle Specialist to provide leadership in identifying and implementing revenue enhancement opportunities while ensuring compliance with third-party payer regulations. The role involves collaborating across various departments to meet gross revenue targets and maintaining accurate charge description masters.

Health CareService IndustryWellness

Responsibilities

Provides leadership to identify and implement hospital revenue enhancement opportunities

Acts as a liaison, consultant and educator for hospital charge capture to leadership, clinical teams, charge entry team members, IT, billing, and purchasing

Maintains accurate and compliant CDM. Regularly reviews vendor CDM data scrubber's compliance reports for assigned service areas and hospital locations and takes necessary action to maximize compliant billing and reimbursement

Collaborates with leadership and clinical teams on annual strategic pricing to meet gross revenue targets

Actively develops with IS liaison, specific Revenue Integrity revenue guardian checks, claim edits, and work queue rules. These revenue validation tools ensure timely billing and accurate reimbursement

Facilitates development, implementation and provide monitoring of operational charge capture processes that meet regulatory compliance and that are effective for end-users

Qualification

Revenue cycle managementHCPCS knowledgeCPT codingEPIC EMR navigationBudget developmentRVUs understandingLeadershipInterpersonal communicationContinuous learning