Revenue Integrity Specialist

SSM Health • Jefferson City, MO

3d • Remote

About The Position

Contributes and supports revenue cycle’s mission for achieving operational efficiency, regulatory compliance and proper reimbursement entitlement. Improves revenue with a basic understanding of the revenue cycle. Analyzes account edits prior to claim submission through monitoring, identifying, and correcting errors. Serves as a resource for health ministry coworkers, clinical/non-clinical, and coding.

Requirements

• Associate’s degree or equivalent combination of education and experience
• One year experience within a hospital organization or physician practice environment
• 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.

Nice To Haves

• Ideal candidate has experience with healthcare revenue cycle, billing and coding, Epic, and has a strong attention to detail.

Responsibilities

• Assists in daily resolution of work que/edits that are holding patient claims from billing by reviewing applicable documentation.
• Identifies, reports, with escalation as needed, and participates in the resolution of any potential or actual revenue/charge related issues.
• Identifies areas of common practice and implements opportunities for standardization.
• Monitors EPIC Revenue Integrity Dashboard(s) in collaboration with ministry liaisons to manage and report out weekly for leadership/colleagues.
• Responds to departmental charging inquiries.
• Provides support for assigned ministries in collaboration with RI Audit team.
• Works with coding and other clinical departments to identify/fix errors based on ICD/CPT coding guidelines and National Correct Coding Initiative (NCCI) edits.
• Contributes to improvement initiatives as directed by department leaders, focusing on WQ accuracy of rules, naming conventions and assignments, and KPIs for performance board as assigned.
• 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: Entry Level
• Education Level: Associate degree