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Revenue-Integrity-Analyst-Intermediate

SSM Health


Location:
St Louis, MO 63112
Date:
10/06/2020
2020-10-062021-02-13
Categories:
  • Healthcare
  • Financial Services
SSM Health
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Job Details

Divison:

At SSM Health, we know the healing power of presence begins with compassionate employees like you. If you love people SSM Health is the place for you. Our mission and values put the patient first and place you in a position to improve each day.

PRIMARY RESPONSIBILITIES AND DUTIES:

+ Demonstrates and imparts the mission, philosophy, values and vision of SSM Health in daily activities and into operational functions, processes and environment.

+ 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. I

+ 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 WQs to ensure account movement through the revenue cycle in a timely manner.

KNOWLEDGE, SKILLS AND ABILITIES:

Understand the Mission and Values of SSM Health and Franciscan Sisters of Mary. Ability to integrate CQI principles and tools into work processes; manage multiple tasks simultaneously, and maintain attention to detail in a dynamic work environment. Understanding of the full Revenue Cycle. Knowledge and experience in maintaining compliance with payer billing/reimbursement policies, Federal regulations, as well as Medicare/CMS guidelines. Knowledge and experience in charge capture/generation Knowledge and experience with EPIC or other electronic health record. Knowledge and experience in coding, using ICD-10, and HCPCs classification systems. Strong interpersonal communication and collaboration skills, and the ability to multitask .

The above level of knowledge, skills, and abilities are acquired through the completion of a minimum of 3-5 years of Revenue Cycle Management experience, within a hospital organization.

PREFFERED

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.

EDUCATION

+ Bachelors degree or work related experience (3 years minimum).

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.
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