• Job Description

  Req#: R163921

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

  MO-REMOTE

  Worker Type:

  Regular

  Job Summary:

  Supports revenue cycle goals of preventing claim denials through auditing, education and training, compliance monitoring, and process improvement of revenue cycle functions. Works closely within and across the organization to identify and reduce claim denials.

  Job Responsibilities and Requirements:

  PRIMARY RESPONSIBILITIES

  • Identifies, analyzes, and researches frequent root causes of denials and develops reporting tools that effectively measure and monitor in order to support process improvement for coding, contracting, and clinical documentation teams.
  • Identifies and communicates denial trends in order to positively affect the volume of denials.
  • Reviews denial data to understand accounts that have been written off to a denial or are in open billing denial status. Performs root cause analysis on the accounts to uncover what caused the denial. Communicates with the impacted teams to identify opportunities for improvement or prevent write offs.
  • Increases accurate claim submission by reviewing, researching, resolving, and trending claim issues and assisting in training and education.
  • Helps develop and implement solutions to reduce initial denials and re-work in the departments.
  • Performs other duties as assigned.

  EDUCATION

  • Bachelor’s degree or equivalent combination of education and experience

  EXPERIENCE

  • Three years’ 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

  Work Shift:

  Day Shift (United States of America)

  Job Type:

  Employee

  Department:

  8701000033 RCO Liaisons/Analysts

  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.

• About the company

  SSM Health is a Catholic, not-for-profit United States health care system with 11,000 providers and nearly 39,000 employees in four states, including Wisconsin, Oklahoma, Illinois, and Missouri.

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