Revenue Integrity Analyst

Talentify; Joplin (MO); On-site; USD 65,000 - 95,000; Full time

Job summary

SSM Health is seeking a Revenue Integrity professional to support the revenue cycle’s mission by improving charge capture and ensuring regulatory compliance. You will analyze data, collaborate with clinical and financial leaders, and design process improvements to optimize reimbursement.

The role requires a Bachelor’s degree with at least three years in a hospital setting, strong knowledge of revenue cycle, and ability to train staff on coding/billing compliance and DTAR/Charge Reconciliation.

Qualifications

• Bachelor’s degree or equivalent combination of education and experience.
• Three years of experience within a hospital organization or physician practice.
• Strong understanding of revenue cycle processes and data integrity.

Responsibilities

• Leads audit/project evaluations according to RI leadership, reviewing documentation for charge accuracy and billing compliance.
• Collaborates with shared coding and financial departments to identify opportunities for additional revenue.
• Meets with leadership to review findings, standards and improvement recommendations; supports dashboards and departmental goals.
• Identifies charge trends and coordinates focused reviews with leadership; monitors EPIC Revenue Integrity dashboards.
• Provides coding, documentation, regulatory and compliance guidance as requested; trains staff on charge accuracy and reconciliation.

Skills

Revenue cycle knowledge

Data integrity

Analytical skills

Education

Bachelor’s degree or equivalent

Tools

EPIC

Microsoft Office

Job description

It's more than a career, it's a calling.

MO-SSM Health Mission Hill

Worker Type:

Regular

Job Highlights:

Qualifications: Demonstrated understanding of revenue cycle processes and data integrity, with strong analytical skills and proficiency in Microsoft Office and Epic. Extensive experience and in-depth knowledge of revenue cycle operations are required to be successful in this role.

Schedule: Full Time, Monday-Friday, Days (option to start as early as 6am)

Location: SSM Health Corporate Office (St. Louis, MO)

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.

Job Summary:

Contributes and supports revenue cycle’s mission for achieving operational efficiency, regulatory compliance and proper reimbursement entitlement. Improves revenue with a comprehensive understanding of the revenue cycle. Collaborates with clinical and financial leaders to strengthen charge capture through data analysis, education and training and compliance monitoring by designing, improving and implementing process improvement. Serves as a resource for health ministry clinicians, coworkers, and coding.

Job Responsibilities and Requirements:

PRIMARY RESPONSIBILITIES

• Leads audit/project evaluations according to RI leadership. Reviews selected medical records documentation to determine accuracy of charges, coding assignments, billing compliance, medical necessity.
• Collaborates with shared coding and financial departments to identify opportunities for additional revenue in accordance with payor guidelines.
• Meets with departmental leadership to review findings, documentation standards and recommendations for improvement. Actively participates in team development, achieving dashboards and in accomplishing departmental goals and objectives.
• Identifies charge trends and compiles information to determine focused reviews of specific departments for leadership. Monitors EPIC Revenue Integrity Dashboard(s) in collaboration with coworkers.
• Provides coding, documentation, regulatory and compliance guidance as requested by departments.
• Assists and directly provides training and orientation in group settings as well as one-on-one, relative to charge accuracy, coding/billing compliance and DTAR/Charge Reconciliation.
• Maintains current knowledge of Charge Description Master (CDM), Charge Preference List (CPL) and Flowsheet Charging to provide support for assigned health ministry to produce a bill/claim.
• Remains current with regulation changes and related operational processes by attending coding conferences, workshops and in-house sessions for updated coding information.
• Contributes to improvement initiatives as directed by department leaders, focusing on KPIs for performance board as assigned.
• Performs other duties as assigned.

EDUCATION

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

EXPERIENCE

• Three years’ experience within a hospital organization or physician practice environment

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.

REQUIRED PROFESSIONAL LICENSE AND/OR CERTIFICATIONS

• None

Department:

8764040033 System Revenue Integrity

Work Shift:

Day Shift (United States of America)

Scheduled Weekly Hours:

40

SSM Health is an Equal Opportunity Employer. SSM Health provides equal employment opportunities to all employees and applicants for employment without regard to race, color, religion, sex, gender, pregnancy, sexual orientation, gender identity, national origin, age, disability, protected veteran status, genetic information, or any other characteristic protected by applicable federal, state, or local law. Click here to learn more.