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Revenue Integrity Coordinator

Company: SCL Health
Location: Broomfield
Posted on: November 10, 2019

Job Description:

YOU.



You bring your body, mind, heart and spirit to your work as a Revenue Integrity Coordinator.



Youre equally comfortable with your interpersonal, technical, and analytical skills.



Youre great at what you do, but you want to be part of something even greater. Because you believe that while individuals can be strong, the right team is invincible.



US.



As a Revenue Integrity Coordinator with us, you will have the opportunity to resolve claim edits prior to billing by analyzing medical record documentation and application of CMS guidance, payer rules, and compliant coding practices.



System Services is our Corporate Headquarters in Broomfield, Colorado and is located within the Oracle campus. SCL Health is a faith-based, nonprofit healthcare organization dedicated to improving the well-being of the people we serve.



Benefits are one of the ways we encourage health for you and your family. Our generous package includes medical, dental and vision coverage. But health is more than a well-working body: it encompasses body, mind and social well-being. To that end, weve launched a Healthy Living program to address your holistic health. Healthy Living includes financial incentives, digital tools, tobacco cessation, classes, counseling and paid time off. We also offer financial wellness tools and retirement planning.



WE.



Together well align mission and careers, values and workplace. Well encourage joy and take pride in our integrity.



Well laugh at each others jokes (even the bad ones). Well hello and high five. Well celebrate milestones and acknowledge the value of spirituality in healing.



Were proud of what we know, which includes how much there is to learn.



YOUR DAY.



As a Revenue Integrity Coordinator, you need to know how to:



* Perform claim workflows that require special attention due to compliant practice notifications from both internal and external sources. Provide Work Que site support for all therapy disciplines, Lab and Cardiac Cath services. Provide back end denial support and review when claims/charges are not accepted by insurance payers.

* Analyze and resolve specific billing edits delaying claims from processing within Epic and/or clearinghouse systems which require clinical knowledge and/or coding expertise, including the verification and/or correction of billing data for accuracy and completeness following regulatory requirements, care site protocols, SCL Health standard, and supported by medical record documentation. Resolution may include charge correction or the application of modifiers, value codes and condition codes, as appropriate.

* Analyze and provide guidance for system changes that are not aligned properly between the organizations operating systems and the billing software utilized by SCL Health. Identify charging, coding, or clinical documentation issues and work with appropriate leadership, ancillary departments, Revenue Service Center, care sites, Charge Master and/or system services to resolve.

* Provide quality assurance to any change made within the workflows overseen by Revenue Integrity with appropriate feedback for continued improvement. Perform compliance charge audits by verifying billing data as compared to documentation and making corrections within Epic as needed. Evaluate system edit logic and provide guidance on enhancements to either begin holding claims for compliance review or remove logic so claims are released without holding. Evaluate and enhance workflows that reside in charge capture, billing, reporting and documentation for hospital based services to maintain a level of compliant billing practices. Identify issues through track and trend analysis of NCCI Code Pair edits and prioritization of identified issues on the annual compliance audit plan for the Revenue Service Center.

* Provide process improvement training to all SCL Health facilities with regard to compliant billing practices when issues are found including the creation and maintenance of training documentation to be shared. Recommend process improvements to care site ancillary department directors in order to improve documentation, charging flow, and accuracy. Develop and maintain educational guidelines. Provide education to care site departments on appropriate code pair edit resolution with emphasis on documentation requirements and correct coding guidelines.



YOUR EXPERIENCE.



We hire people, not resumes. But we also expect excellence, which is why we require:



* High School Diploma or equivalent, required

* Associates Degree in a healthcare related field (i.e. health information technology, revenue cycle/finance/business), preferred

* Minimum of three (3) years of work experience related to healthcare compliance, charge capture, coding and/or hospital billing processes, required

* At least five (5) years of work experience related to healthcare compliance, charge capture, coding and/or hospital billing processes, preferred

* Previous experience with EPIC/Emdeon, preferred

* Certified Coder through AAPC or AHIMA, preferred



YOUR NEXT MOVE.



Now that you know more about being a Revenue Integrity Coordinator on our team we hope youll join us. At SCL Health youll reaffirm every day how much you love this work, and why you were called to it in the first place.



Located in Broomfield, CO.



Our facilities do not discriminate against any person on the basis of race, color, national origin, disability, or age in admission or access to, or treatment or employment in, its programs, services or activities, or on the basis of sex (gender) in health programs and activities

Keywords: SCL Health, Broomfield , Revenue Integrity Coordinator, Other , Broomfield, Colorado

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