Missouri Professional Services Jobs

Jobs.mo.gov mobile logo

Job Information

SSM Health Spv-Corporate Responsibility in Saint Louis, Missouri

Divison:

Fantastic opportunity with SSM to take your career to the next level. Must have CPC Certification or AHIMA Certification. This role has the ability to be remote within the SSM network which includes St. Louis, Wisconsin, Oklahoma, or Illinois.

PRIMARY RESPONSIBILITIES

  • Assists leadership in the oversight and implementation of the corporate responsibility process (CRP) for assigned regulatory and operational functions, including compliance awareness education, implementation and maintenance of compliance policies and procedures, and monitoring of policy adherence and enforcement.

  • Supervises staff and related processes to ensure implementation, monitoring and enforcement of compliance and regulatory guidance.

  • Responsible for the supervision of staff in the performance of audits and investigations of high risk compliance issues, including but not limited to billing, coding, and governmental audit issues or findings.

  • Prepares and delivers reports and updates to CRP, front line, and senior leaders outlining areas of concern and/noncompliance.

  • Serves as a resource to assigned regulatory and operational functions in establishing methods to improve regulatory and legal compliance and reduce vulnerability to fraud, abuse, and waste.

  • Collaborates to periodically revise system policies and processes in light of changes in laws and regulations stemming from government and private payer plans.

  • Remains current with government and third party billing regulations, government initiatives on fraud and abuse, and other related legislation.

  • Serves as a resource to all internal and external customers, answering questions, researching topics and providing information regarding coding, documentation and compliance issues.

  • Partners with other individuals/departments to foster best practice methodology and compliance.

  • Performs other duties as assigned.

EDUCATION

  • Bachelor’s degree or equivalent combination of experience and education

EXPERIENCE

  • Minimum five years’ experience, with at least two years supervising a team

PHYSICAL REQUIREMENTS

  • Frequent lifting/carrying and pushing/pulling objects weighing 0-25 lbs.

  • Frequent sitting, standing, walking, reaching and repetitive foot/leg and hand/arm movements.

  • Frequent use of vision and depth perception for distances near (20 inches or less) and far (20 feet or more) and to identify and distinguish colors.

  • Frequent use of hearing and speech to share information through oral communication. Ability to hear alarms, malfunctioning machinery, etc.

  • Frequent keyboard use/data entry.

  • Occasional bending, stooping, kneeling, squatting, twisting and gripping.

  • Occasional lifting/carrying and pushing/pulling objects weighing 25-50 lbs.

  • Rare climbing.

SSM Health is committed to equal employment opportunity based on race, color, religion, national origin, gender, sexual orientation, gender identity, pregnancy, age, physical or mental disability, veteran status, and all other statuses protected by law.

DirectEmployers