Apply on Employer Site

SSM Health · 5 hours ago

Revenue Cycle Regulatory Research Analyst

United States

Full-time

Remote

Mid Level

3+ years exp

SSM Health is dedicated to providing exceptional patient care and making a difference in people's lives. The Revenue Cycle Regulatory Research Analyst supports the system’s revenue cycle by managing regulatory oversight and ensuring compliance with federal, state, and local mandates related to billing and coding processes.

Health Care

Responsibilities

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

Works with revenue cycle and operational departments to assess, oversee, and recommend business practices to ensure adherence to and compliance with State and Federal regulatory billing guidelines

Interprets and analyzes state and federal regulatory rules, contracts, and other guidance to assess compliance and support building appropriate procedures and workflows

Communicates summarized potential impacts of regulatory or payer guideline changes to affected leaders with recommended action plans

Develops informative educational materials for any changes and/or updates

Serves as a subject matter expert on existing and proposed regulations related to Medicare, Medicaid and other payer charging/billing processes including those promulgated under health care reform

Reviews Medicare intermediary and third-party payer bulletins, memos, and websites to keep current on coding requirements and pending changes, communicating relevant information to all applicable departments

Performs Ad Hoc research related to billing and coding questions as needed

Performs other duties as assigned

Qualification

Compliance experienceRevenue Cycle knowledgeRegulatory analysisData analyticsEducational material developmentResearch skillsCommunication skillsTeam collaborationProblem-solvingAttention to detailAdaptability

Required

Compliance experience with a focus on Revenue Cycle is strongly preferred

Bachelor's degree or equivalent years of experience and education

Three years' experience

State of Work Location: Illinois, Missouri, Oklahoma, Wisconsin

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 Risk Adjustment Coder (CRC) - 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 - 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)

Registered Health Information Technician (RHIT) - American Health Information Management Assoc (AHIMA)

Benefits

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.