Revenue Integrity Coordinator-16007343 Care Site Description SCL Health is a faith-based, nonprofit health care organization headquartered in Broomfield with facilities located in Colorado, Kansas and Montana. SCL Health operates: 9 hospitals 4 safety net clinics 1 children's mental health treatment center 190+ ambulatory service centers Interested in making a difference? Then check us out. Our rich heritage and mission, and our focus on health care delivery that values person-centered care, excellence and accountability are a winning combination as we bring health—and hope—to our patients. Our ministry is dedicated to improving the health of the communities and individuals we serve, especially those who are poor and vulnerable. Visit www.sclhealthsystem.org Description The Revenue Integrity Coordinator will work designated accounts to resolve claim edits prior to billing by analyzing medical record documentation and application of CMS guidance. This position will evaluate and provide guidance related to billing or clearinghouse system edits. This position will also provide guidance and education to care site departments related to charging, coding, modifiers, value codes, and required medical record documentation to support accurate billing. It will also assist with internal audit analysis identified by Audit and Reimbursement. · Analyze and resolve specific billing edits delaying claims from processing within Epic and/or clearinghouse systems which require clinical knowledge and/or coding expertise. This includes 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. · Provide analysis and guidance for system changes that are not aligned properly between the organizations operating systems and the billing software utilized by SCL Health. · 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. · 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. · Perform compliance charge audits by verifying billing data as compared to documentation and making corrections within Epic as needed. Recommend process improvements to care site ancillary department directors in order to improve documentation, charging flow, and accuracy. Qualifications Requires: Associate degree in healthcare related field 3-5 years current experience related to healthcare compliance, charge capture, coding and/or hospital billing processes Demonstrates understanding of entire revenue cycle with emphasis on coding and Charge Master build/maintenance. Demonstrates high level of understanding of Anatomy and physiology of the human body. Expert knowledge of CPT/HCPCS coding rules regulations and practices. Proficiency in Microsoft Office suite, Power Point and Outlook with the ability to present data and analysis in a clear manner. Prefer: Bachelor's degree in healthcare related field Certified Coder through AAPC or AHIMA 5+ years current experience related to healthcare compliance, charge capture, coding and/or hospital billing processes Knowledge and experience with Epic/Emdeon preferred Organization: Corporate, Various Locations Primary Location: CO-Denver/Boulder/Surrounding Areas-Broomfield Department: SYS-RSC Administration Schedule: Full-time Shift: Day Shift Job Posting: Dec 8, 2016, 11:39:17 AM FTE: 1.0 Accounting and Finance
We reveal and foster God's healing love by improving the health of the people and communities we serve, especially those who are poor and vulnerable.
Inspired by our faith,
•We will be distinguished as the premier person-centered health system and trusted partner.
•We will share accountability with clinicians and other stakeholders to coordinate care across all settin...gs and improve access, quality, health outcomes, and affordability.
•We will grow as community-based health networks to serve more people in partnerships with others who share our vision and values.
Caring Spirit - We honor the sacred dignity of each person.
Excellence - We set and surpass high standards.
Good Humor - We create joyful and welcoming environments.
Integrity - We do the right thing with openness and pride.
Safety - We deliver care that seeks to eliminate all harm for patients and associates.
Stewardship - We are accountable for the resources entrusted to us.