It's more than a career, it's a calling

MO-REMOTE

Worker Type:

Regular

Job Highlights:

Named 150 Top Places to Work in Healthcare 2023 - Becker's Healthcare

Named One of America's Greatest Workplaces for Diversity 2023 - Newsweek

Named One of America's Greatest Workplaces for Women 2023, 2024 - Newsweek

SSM Health is a Catholic, not-for-profit health system serving the comprehensive health needs of communities across the Midwest through a robust and fully integrated health care delivery system. The organization’s 40,000 team members and more than 12,800 providers are committed to providing exceptional health care services and revealing God’s healing presence to everyone they serve.
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With care delivery sites in Illinois, Missouri, Oklahoma and Wisconsin, SSM Health includes 23 hospitals, more than 300 physician offices and other outpatient and virtual care services, 13 post-acute facilities, comprehensive home care and hospice services, a pharmacy benefit company, a health insurance company and an accountable care organization. It is one of the largest employers in every community it serves.

To request additional information, confidentially submit your interest, or nominate a fellow colleague, please contact:

Jon Dirksen

Executive Talent Partner

jon.dirksen@ssmhealth.com

#LI-Remote

SSM Health is committed to equal employment opportunity based on race, color, religion, national origin, gender, sexual orientation, gender identity, pregnancy, age, physical or mental disability, veteran status, and all other statuses protected by law.

Job Summary:

Directs day to day activities of regulatory coordinators to ensure all necessary regulatory updates are researched and assessed for departmental compliance. Educates and informs revenue cycle departments of any impending government or state regulations that impact the revenue cycle, with a focus on acute and ambulatory coding and billing. Provides revenue regulatory guidance (coding/billing) to ensure compliant billing and coding practices within the organization. Provides insight to potential changes that are proposed in efforts to proactively plan for operational changes.

Job Responsibilities and Requirements:

Primary Responsibilities

Directs a coordinated regulatory research program for the organization. Participates as a regulatory resource for the revenue cycle. Works to resolve regulatory compliance, coding, and billing issues timely and facilitates communication of regulatory related matters.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.Oversees written and verbal communication shared for education on regulatory and payor changes.Ensures extensive knowledge Medicare IPPS, and OPPS and state regulated payors (Medicaid) within the regulatory coordinators is maintained to cascade knowledge to appropriate revenue cycle teams.Influences revenue cycle operations and coding staff and provides operational guidance to the appropriate leadership team in coding and charging. Optimizes reimbursement and reduces compliance risks.Serves as point of contact for internal/external revenue cycle compliance, coding, and financial regulatory initiatives.Performs routine regulatory research and provides guidance to the revenue cycle partners on regulatory changes, or in response to requests for interpretive guidance on billing or regulatory concerns.Promotes consistency in coding audit and regulatory education process for employed physicians, advanced practice professionals, and coders.Develops and maintains a multidisciplinary team to evaluate CMS, government, and commercial regulatory initiatives to evaluate systemic concerns or necessary process changes.Recruits, engages, develops, leads, and manages assigned staff.Performs other duties as assigned.

Education

Bachelor’s Degree

Experience

Seven years' experience, with five years in direct people management/leadership

Required Professional License and/or Certifications 

Certified Coding Associate (CCA) - American Health Information Management Assoc (AHIMA), Certified Coding Specialist (CCS) - American Health Information Management Assoc (AHIMA), Certified Coding Specialist - Physician-based (CCS-P) - American Health Information Management Assoc (AHIMA), Certified Healthcare Financial Professional (CHFP) - Healthcare Financial Management Association (HFMA), Certified Outpatient Coder (COC) - American Academy of Professional Coders (AAPC), Certified Professional Coder (CPC®) - American Academy of Professional Coders (AAPC), Certified Revenue Cycle Representative (CRCR) – GCC for international audience - Healthcare Financial Management Association (HRMA), Certified Revenue Cycle Representative (CRCR) - Healthcare Financial Management Association (HFMA), Certified Specialist Accounting and Finance (CSAF) - Healthcare Financial Management Association (HRMA), Certified Specialist Business Intelligence (CSBI) - Healthcare Financial Management Association (HRMA), Certified Specialist Payment and Reimbursement (CSPR) - Healthcare Financial Management Association (HRMA), Certified Specialist Physician Practice Management (CSPPM) - Healthcare Financial Management Association (HRMA), Executive of Healthcare Revenue Cycle (EHRC) - Healthcare Financial Management Association (HRMA), Fellow of the Healthcare Financial Management Association (FHFMA) - Healthcare Financial Management Association (HRMA), 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:

8702000033 HB Coding

Scheduled Weekly Hours:40

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.