Revenue Practice Payer Integrity Coordinator - Intermountain Health
Trenton, NJ
About the Job
Job Description:
Quality Analyst/Engineer-Senior is responsible to ensure software quality through testing software / software platforms for specific business needs including: enhancements, maintenance, and defect fixes. Senior-level professional experienced in all aspects of quality assurance and testing. Encompasses full knowledge required within the quality and software development lifecycle. Typically designs and develops approaches that are implemented by others. Functions with minimal oversight and direction. Provides technical guidance to peers.
Scope
1.Monitors federal and state regulations that impact revenue cycle. Partners with the revenue cycle management team to operationalize regulatory requirements.
2. Disseminates information, coordinate and track with the subject matter experts to ensure process changes are in place to support compliance with existing and proposed regulations.
3. Facilitates and chairs the RSC Revenue Integrity
Payer Committee.
4. Provides research, seeks legal advisement and partners with operational owners implementing government payer changes.
5. Collaborates with the Sr. Director and Directors in RSC, educates the applicable leaders and associates on background information, articles, and other tools regarding RSC compliance risk areas. Provides communication and education to revenue cycle management team and department associates through huddles, staff meetings and other forms of communication to relay updates regarding compliance matters.
6. Utilizes the approved Regulatory Communication format, communicates changes to Compliance leadership and identifies appropriate associates and leaders.
7. Tracks adherence to RSC disseminated information and maintains historical documentation as required by the SCL Health retention process.
8. Promotes mission, vision, and values of SCL Health, and abides by service behavior standards.
9. Performs other duties as assigned.
Minimum Qualifications
Required
Bachelor's Degree in Healthcare Management or related field is required
Certification in Healthcare Compliance from Health Care Compliance Association(HCCA) within one (1) year of hire date is required
Five (5) years experience in an acute healthcare system revenue cycle area with compliance responsibilities working directly with Medicare and Medicaid regulations is required
Preferred
Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT) is preferred
One (1) year in a clinical role in an acute setting is preferred
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements list must be representative of the knowledge, skills, minimum education, training, licensure, experience, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
1. Regular attendance to perform work on site during regularly scheduled business hours or scheduled shifts is required.
2. Strong knowledge base of current Medicare and Medicaid regulations.
3. Working knowledge of medical terminology, billing, reimbursement and coding guidelines in both hospital and physician practices.
4. Advanced communication skills
5. Awareness and ability to implement the principles of process improvement.
6. Ability to balance operating requirements with compliance issues.
7. Able to establish and maintain effective written and oral communication with providers, staff, departments, management and government entities.
Physical Requirements:
Interact with others by effectively communicating, both orally and in writing.- and -Operate computers and other office equipment requiring the ability to move fingers and hands.- and -See and read computer monitors and documents.- and -Remain sitting or standing for long periods of time to perform work on a computer, telephone, or other equipment.- and -May require lifting and transporting objects and office supplies, bending, kneeling and reaching.
Location:
Peaks Regional Office
Work City:
Broomfield
Work State:
Colorado
Scheduled Weekly Hours:
40
The hourly range for this position is listed below. Actual hourly rate dependent upon experience.
$35.29 - $55.57
We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.
Learn more about our comprehensive benefits packages for our Idaho, Nevada, and Utah based caregivers (https://intermountainhealthcare.org/careers/working-for-intermountain/employee-benefits/) , and for our Colorado, Montana, and Kansas based caregivers (http://www.sclhealthbenefits.org) ; and our commitment to diversity, equity, and inclusion (https://intermountainhealthcare.org/careers/working-for-intermountain/diversity/) .
Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.
All positions subject to close without notice.
Quality Analyst/Engineer-Senior is responsible to ensure software quality through testing software / software platforms for specific business needs including: enhancements, maintenance, and defect fixes. Senior-level professional experienced in all aspects of quality assurance and testing. Encompasses full knowledge required within the quality and software development lifecycle. Typically designs and develops approaches that are implemented by others. Functions with minimal oversight and direction. Provides technical guidance to peers.
Scope
1.Monitors federal and state regulations that impact revenue cycle. Partners with the revenue cycle management team to operationalize regulatory requirements.
2. Disseminates information, coordinate and track with the subject matter experts to ensure process changes are in place to support compliance with existing and proposed regulations.
3. Facilitates and chairs the RSC Revenue Integrity
Payer Committee.
4. Provides research, seeks legal advisement and partners with operational owners implementing government payer changes.
5. Collaborates with the Sr. Director and Directors in RSC, educates the applicable leaders and associates on background information, articles, and other tools regarding RSC compliance risk areas. Provides communication and education to revenue cycle management team and department associates through huddles, staff meetings and other forms of communication to relay updates regarding compliance matters.
6. Utilizes the approved Regulatory Communication format, communicates changes to Compliance leadership and identifies appropriate associates and leaders.
7. Tracks adherence to RSC disseminated information and maintains historical documentation as required by the SCL Health retention process.
8. Promotes mission, vision, and values of SCL Health, and abides by service behavior standards.
9. Performs other duties as assigned.
Minimum Qualifications
Required
Bachelor's Degree in Healthcare Management or related field is required
Certification in Healthcare Compliance from Health Care Compliance Association(HCCA) within one (1) year of hire date is required
Five (5) years experience in an acute healthcare system revenue cycle area with compliance responsibilities working directly with Medicare and Medicaid regulations is required
Preferred
Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT) is preferred
One (1) year in a clinical role in an acute setting is preferred
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements list must be representative of the knowledge, skills, minimum education, training, licensure, experience, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
1. Regular attendance to perform work on site during regularly scheduled business hours or scheduled shifts is required.
2. Strong knowledge base of current Medicare and Medicaid regulations.
3. Working knowledge of medical terminology, billing, reimbursement and coding guidelines in both hospital and physician practices.
4. Advanced communication skills
5. Awareness and ability to implement the principles of process improvement.
6. Ability to balance operating requirements with compliance issues.
7. Able to establish and maintain effective written and oral communication with providers, staff, departments, management and government entities.
Physical Requirements:
Interact with others by effectively communicating, both orally and in writing.- and -Operate computers and other office equipment requiring the ability to move fingers and hands.- and -See and read computer monitors and documents.- and -Remain sitting or standing for long periods of time to perform work on a computer, telephone, or other equipment.- and -May require lifting and transporting objects and office supplies, bending, kneeling and reaching.
Location:
Peaks Regional Office
Work City:
Broomfield
Work State:
Colorado
Scheduled Weekly Hours:
40
The hourly range for this position is listed below. Actual hourly rate dependent upon experience.
$35.29 - $55.57
We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.
Learn more about our comprehensive benefits packages for our Idaho, Nevada, and Utah based caregivers (https://intermountainhealthcare.org/careers/working-for-intermountain/employee-benefits/) , and for our Colorado, Montana, and Kansas based caregivers (http://www.sclhealthbenefits.org) ; and our commitment to diversity, equity, and inclusion (https://intermountainhealthcare.org/careers/working-for-intermountain/diversity/) .
Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.
All positions subject to close without notice.
Source : Intermountain Health