"Alerted.org

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.

Job Responsibilities and Requirements:

PRIMARY 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.

EDUCATION

+ Bachelor's degree or equivalent years of experience and education

EXPERIENCE

+ Three years' experience

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

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)

Work Shift:

Day Shift (United States of America)

Job Type:

Employee

Department:

8700080033 Regulatory Research RCO

Scheduled Weekly Hours:

40

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.

Explore All Benefits (https://jobs.ssmhealth.com/us/en/benefits)

_SSM Health is an equal opportunity employer. SSM Health does not discriminate on the basis of race, color, religion, national origin, age, disability, sex, sexual orientation, gender identity,_ _pregnancy, veteran status_ **_,_** _or any other characteristic protected by applicable law._ Click here to learn more. (https://www.ssmhealth.com/privacy-notices-terms-of-use/non-discrimination?\_ga=2.205881493.704955970.1667719643-240470506.1667719643)