Revenue Integrity Audit Specialist
SSM Health
**It's more than a career, it's a calling.**
MO-SSM Health St. Mary's Hospital - St. Louis
**Worker Type:**
Regular
**Job Highlights:**
_Supports Diagnostic Imaging as a subject matter expert for achieving operational efficiency, compliance, and exceptional patient care. Serves as a liaison between and resource for clinical and Revenue/Financial departments with strong understanding of both components. Ensures best practices are utilized throughout the St. Louis Imaging Network._
**Job Summary:**
Supports assigned department(s) as a subject matter expert for achieving operational efficiency, compliance, and exceptional patient care. Serves as a liaison between and resource for clinical and Revenue/Financial departments with strong understanding of both components.
**Job Responsibilities and Requirements:**
PRIMARY RESPONSIBILITIES
+ Serves as a resource and subject matter expert to the for department workflows, documentation, coding, charging, and software applications.
+ Manages all work queues using subject matter expertise to investigate/correct errors to aid in timely and accurate claims.
+ Investigates clinical & technical report deficiencies to ensure all reports are completed timely to prevent delays in patient care.
+ Ensures accuracy & completeness of daily charges/CPT code assignment; applying modifiers as needed & ensure supporting documentation is present.
+ Work one-on-one with staff and Physicians to ensure documentation requirements are being met according to coding & billing guidelines.
+ Create and generate reports utilizing multiple reporting tools across multiple databases to support leadership on strategic initiatives.
+ Completes audit/project evaluations and reviews selected records to determine accuracy of orders, charges, and documentation. Shares findings with leadership and collaborates to achieve departmental goals, objectives, and best practice.
+ 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 by attending coding conferences, workshops, and self-guided learning.
+ Collaborates with management and subject matter experts to understand the desired performance, assess learning needs, and develops appropriate training solutions. Provides ongoing training relative to charge accuracy & department specific workflows that impact coding/billing compliance and delivery of timely patient results.
+ Performs other duties as assigned.
EDUCATION
+ Associate's degree
EXPERIENCE
+ Two years of experience in assigned department(s) or coding 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
+ None
**Department:**
4218000130 Imaging Admin
**Work Shift:**
Day Shift (United States of America)
**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)_
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