Revenue Integrity Coding Specialist - CPC

Revenue Integrity Coding Specialist - CPC Required

Apply for the Revenue Integrity Coding Specialist - CPC Required role at Trinity Health
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Employment Type
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Full time

Shift
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Day Shift

Description Summary
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This is a Monday‑Friday, 8 a.m.‑5 p.m. remote position that requires certification. For the Holy Cross Medical Group, the individual performs charge entry, charge approvals, and/or quality charge reviews; including but not limited to appending modifiers and checking clinical documentation. Works closely with Revenue Integrity staff and providers to educate on improved documentation to support coding. Neurosurgery experience is highly preferred.

CPC license is required.

What You Will Do

• Responsible for coding and/or validation of charges for more complex service lines with advanced proficiency in surgical or specialty coding practice.
• Review charts—nursing notes, physician orders, progress notes, and surgical or specialty notes—to interpret, validate, and extract all charges, ensuring each chart is complete per guidelines and that charges are captured on the correct patient, encounter, date of service, and any required modifiers.
• Review documentation and abstract data to ensure charges/coding align with AMA and Medicare guidelines and comply with federal, state, and private payer regulations.
• Perform coding functions, including CPT and ICD‑10 assignment, documentation review, and claim denial review.
• Proof daily charges for accuracy and clean claim submission.
• Balance charges and adjustments.
• Maintain productivity and regulatory compliance standards.
• Coordinate denials with PBS centers, analyze clinical documentation, assist in appeals, root cause analysis, and tracking.
• Educate clinical staff on the need for accurate and complete documentation to ensure revenue optimization and integrity.
• Conduct outpatient clinical documentation improvement review (acute only) as needed.
• Research charges and communicate findings to intra‑ and inter‑departmental colleagues.
• Maintain a minimum productivity standard based on service line and charge type—including chart review, charge extraction, E/M level assignment, and charge entry.

Minimum Qualifications

• High school diploma or equivalent combination of education and experience.
• Minimum three (3) years of relevant coding and charge control experience in a hospital and/or physician practice environment, and experience in revenue cycle, billing, coding, and/or patient financial services.
• Strong working knowledge of medical terminology, data entry, supply chain processes, hospital and/or medical group practice operations.
• CPC license required.
• Neurosurgery experience preferred.
• Demonstrated knowledge of clinical processes, coding (CPT, HCPCS, ICD‑9/10, revenue codes, and modifiers), charging processes and audits, and clinical billing; strong understanding of various medical claim formats.
• Knowledge of clinical documentation improvement processes strongly preferred.
• Strong knowledge of APC, OPPS reimbursement structures and pre‑bill edits including OCE/CCI edits and DNFB.
• Ability to perform charge capture processes, including understanding of EMR technical integration and automation of charge triggers, and investigate charge errors. Epic experience desired.

Position Highlights And Benefits

• Comprehensive benefit packages, including medical, dental, vision, paid time off, 403(b), and education assistance.
• Benefits start on your first day of work.
• Retirement savings program with employer matching.
• We serve together in the spirit of the Gospel as a compassionate and transforming healing presence within our communities.
• We live and breathe our guiding behaviors: we support each other in serving, we communicate openly, honestly, respectfully, and directly, we are fully present, we are all accountable, we trust and assume goodness in intentions, and we are continuous learners.

Ministry/Facility Information

• Trinity Health is one of the largest multi‑institutional Catholic health care delivery systems in the nation. Its Fort Lauderdale‑based Holy Cross Hospital, dba Holy Cross Health, is a full‑service, not‑for‑profit, Catholic, teaching hospital operating in the spirit of the Sisters of Mercy.
• We are…