Revenue Cycle Regulatory Research Analyst

SSM Health Care • Jefferson City, MO

6d • Remote

About The Position

It's more than a career, it's a calling MO-REMOTE Worker Type: Regular Job Highlights: Qualifications: Compliance experience with a focus on Revenue Cycle is strongly preferred. Schedule: Full Time, Days (business hours) Location: Remote - reside in MO, IL, OK, or WI At SSM Health, we believe in providing our employees with a fulfilling career. We strive to create an environment where individuals can grow both personally and professionally. Our company values diversity, innovation, and collaboration, and we are committed to making a positive impact on the communities we serve. Joining SSM Health means becoming part of a team that is dedicated to providing exceptional patient care and making a difference in people's lives. Our employees are passionate about what they do, and their commitment to our mission is what sets us apart. Remote work: This position may be eligible for remote work in accordance with SSM policies. Note that remote work is not permissible in some states; Human Resources should be consulted for additional information and guidance. Candidates must reside in MO, IL, OK, or WI Job Summary: Supports the system's revenue cycle by serving as regulatory oversight and regulatory change management duties for current and new lines of business and expansion efforts. Acts as subject matter expert; interprets payer guidelines for clean claim submission; develops and analyzes trend reports; researches, interprets, and provides guidance on federal, state, and local regulatory mandates, payer policies and contracts. Responsible for performing in-depth analysis of proposed and final rules to ensure revenue cycle departments are aware and informed with changes to support operational compliance.

Requirements

• Bachelor's degree or equivalent years of experience and education
• Three years' experience
• 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.
• State of Work Location: Illinois, Missouri, Oklahoma, Wisconsin
• Certified Coding Associate (CCA) - American Health Information Management Assoc (AHIMA) Or Certified Coding Specialist (CCS) - American Health Information Management Assoc (AHIMA) Or Certified Coding Specialist - Physician-based (CCS-P) - American Health Information Management Assoc (AHIMA) Or Certified Healthcare Financial Professional (CHFP) - Healthcare Financial Management Association (HFMA) Or Certified Outpatient Coder (COC) - American Academy of Professional Coders (AAPC) Or Certified Professional Coder (CPC®) - American Academy of Professional Coders (AAPC) Or Certified Risk Adjustment Coder (CRC) - American Academy of Professional Coders (AAPC) Or Certified Revenue Cycle Representative (CRCR) - GCC for international audience - Healthcare Financial Management Association (HRMA) Or Certified Revenue Cycle Representative (CRCR) - Healthcare Financial Management Association (HFMA) Or Certified Specialist Accounting and Finance (CSAF) - Healthcare Financial Management Association (HRMA) Or Certified Specialist Business Intelligence (CSBI) - Healthcare Financial Management Association (HRMA) Or Certified Specialist Payment and Reimbursement (CSPR) - Healthcare Financial Management Association (HRMA) Or Certified Specialist Physician Practice Management (CSPPM) - Healthcare Financial Management Association (HRMA) Or Executive of Healthcare Revenue Cycle - Healthcare Financial Management Association (HRMA) Or Fellow of the Healthcare Financial Management Association (FHFMA) - Healthcare Financial Management Association (HRMA) Or Registered Health Information Administrator (RHIA) - American Health Information Management Assoc (AHIMA) Or Registered Health Information Technician (RHIT) - American Health Information Management Assoc (AHIMA)

Nice To Haves

• Compliance experience with a focus on Revenue Cycle is strongly preferred.

Responsibilities

• Identifies and evaluates emerging compliance, coding, and financial risks, utilizing regulatory guidance, resources, and data analytics on an ongoing basis to educate and implement leading regulatory compliant practices.
• Works with revenue cycle and operational departments to assess, oversee, and recommend business practices to ensure adherence to and compliance with State and Federal regulatory billing guidelines.
• Interprets and analyzes state and federal regulatory rules, contracts, and other guidance to assess compliance and support building appropriate procedures and workflows.
• Communicates summarized potential impacts of regulatory or payer guideline changes to affected leaders with recommended action plans.
• Develops informative educational materials for any changes and/or updates.
• Serves as a subject matter expert on existing and proposed regulations related to Medicare, Medicaid and other payer charging/billing processes including those promulgated under health care reform.
• Reviews Medicare intermediary and third-party payer bulletins, memos, and websites to keep current on coding requirements and pending changes, communicating relevant information to all applicable departments.
• Performs Ad Hoc research related to billing and coding questions as needed.
• Performs other duties as assigned.

Benefits

• SSM Health values our exceptional employees by offering a comprehensive benefits package to fit their needs.
• Paid Parental Leave : we offer eligible team members one week of paid parental leave for newborns or newly adopted children (pro-rated based on FTE).
• Flexible Payment Options: our voluntary benefit offered through DailyPay offers eligible hourly team members instant access to their earned, unpaid base pay (fees may apply) before payday.
• Upfront Tuition Coverage : we provide upfront tuition coverage through FlexPath Funded for eligible team members.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 5,001-10,000 employees