SSM Health Revenue Integrity Analytic Specialist in St. Louis, Missouri

Description

Role Purpose:

Supports SSM St. Louis Network revenue cycle goals through data analysis, auditing, education and training, compliance monitoring, and process improvement of revenue cycle functions. Serves as a resource for all Health Ministry coworkers, clinical/non clinical, and coding to ensure revenue integrity and entitlement.

Responsibilities:

  • Works effectively as a team member in a dynamic executive environment where collegiality, subsidiary and sharing responsibility is required and highly valued within a matrix organization. Promotes teamwork within and across the network by maintaining positive and productive intra-entity and intradepartmental relationships and utilizing effective problem solving skills.

  • Adheres to the SSM Health Standards of Ethical Conduct, displaying, as applicable, ethical behavior in the areas of business ethics, legal compliance, confidentiality, conflicts of interest, vendor relationships and the reporting of questionable activities.

  • Improve the overall patient care experience by providing revenue cycle support to all departments across the SSMH St. Louis Network.

  • Understands, embraces and models the SSMH exceptional service standards.

  • Ensures SSMH billing guidelines are compliant with governmental, and commercial payer regulations for claim presentation based on documentation, charging, billing, and reimbursement processes.

  • Enhances net revenue by performing audits to identify and capture all entitled revenue.

  • Root cause analysis of charging issues, billing issues for denials and underpayments for improvement opportunities.

  • Increases accurate claim submission by reviewing, researching, resolving, and trending claim issues, and assisting in training and education.

  • Maintains assigned Health Ministry dashboards; unit department and various WQ’s to ensure account movement through the revenue cycle in a timely manner

Qualifications

Minimum Qualifications:

  • Bachelor’s degree or at least 3 years of work related experience

Preferred Qualifications:

  • Certification in Nursing (RN, BSN) or Coding (ie., CCS/COC/RHIT/RHIA).

  • Experience with National/Local coverage determination guidelines for hospital and professional environments, SSI, EPIC, Resolute, Computer, Microsoft Office, Coding, Billing, Compliance and good analytical and communication skills.

SSM Health - System Office

SSM Health is one of the largest Catholic health systems in the country and is dedicated to quality and compassionate care for anyone in need, regardless of ability to pay. Based in St. Louis, where its System Office is located, SSM Health operates 20 hospitals in Wisconsin, Illinois, Missouri and Oklahoma. We provide care in various settings: outpatient sites, physician offices, a pharmacy benefit company, an insurance plan, hospitals, nursing homes, home care, hospice, telehealth and a technology company. Our Mission: Through our exceptional health care services, we reveal the healing presence of God.

Benefits Statement:

Our robust employee benefits package includes health benefits, life and accidental death and dismemberment insurance, long-term disability coverage, health and dependent care reimbursement accounts, paid time off, tuition reimbursement, adoption reimbursement, an employee assistance program, retirement plan options and more.

Note: not all benefits apply to all openings.

Job: Clinical Support & Technical Services

Primary Location: Missouri-St. Louis-SSM Health St. Mary’s Hospital – St. Louis

Work Locations SSM Health St. Mary’s Hospital – St. Louis 6420 Clayton Road St. Louis 63117

Organization SSM Health - System Office

Schedule Full Time, Days

Normal work hours 8am-430pm

Scheduled Hrs Per Pay Period 80

Posting Nov 29, 2018, 2:20:02 PM

Req ID: 18016398