Revenue Integrity Specialist Full-Time Days

Employment Type: Full time Shift: Day Shift Description: At Saint Alphonsus Health System, we are looking for people who are living out their calling. We want you to be passionate about coming to work, and challenged to achieve your potential. Living by these virtues, we pride ourselves on exceptional service and the highest quality of care. GENERAL SUMMARY AND PURPOSE: The primary responsibility of the Revenue Integrity Officer is to support the Saint Alphonsus Health System Revenue Integrity Program by assisting with development and implementation of processes and systems to identify and decrease potential risk areas related to compliance with federal, state and other third party billing regulations related to hospital and professional services. The Revenue Integrity Officer will assist with the development and monitoring of internal auditing and monitoring procedures for inpatient, outpatient and clinic services and development of appropriate corrective action plans and monitor for timely completion. The Revenue Integrity Officer will provide staff education to colleagues in an effort to further mitigate risks to the organization. The Revenue Integrity Officer will serve as a member of specific committees focused on billing compliance and provide support other general compliance activities by serving as the integrity and compliance representative for one of the hospitals within Saint Alphonsus Health System. SKILLS, KNOWLEDGE, EDUCATION AND EXPERIENCE: Bachelor's degree preferred or equivalent experience/education in coding and documentation requirements, reimbursement methodologies and health care billing compliance. Specialized knowledge and experience regarding hospital and/or professional coding rules and regulations and billing and reimbursement methodologies. Certifications in healthcare compliance and coding preferred. Minimum of five years' experience in hospital and/or professional coding, billing reimbursement ESSENTIAL FUNCTIONS: Knows, understands, incorporates, and demonstrates the Organization's Mission, Vision, and Values in behaviors, practices, and decisions. Knows internal procedures and identifies process improvement opportunities regarding compliance with billing regulations, and assists with implementation and monitoring for consistency and sustainability. Works closely with hospital and clinic charge entry teams to identify potential risk areas and participates in the risk assessment and work plan planning process. Conducts internal investigations related to revenue integrity matters as directed by the System Revenue Integrity Officer. Maintains a working knowledge of existing and proposed regulatory requirements related to hospital and professional coding, billing, reimbursement methodologies, conditions of participation, conditions of payment and general integrity and compliance matters. Assists with and develops on-going training and education and general awareness efforts for colleagues, medical staff, board members, volunteers and external customers in support of the Saint Alphonsus Health System Revenue Integrity Program and as needed for the Saint Alphonsus Health System Integrity and Compliance Program . Regularly reports to the Saint Alphonsus Health System Revenue Integrity Council, as needed to the Saint Alphonsus Health System Integrity and Compliance Council, and to other key stakeholders or leaders on revenue integrity matters. Tracks and maintains appropriate documentation related to revenue integrity and other organizational integrity issues as requested or required. Participates in regular Trinity Health Integrity and Compliance related committees and other local groups that focus on compliance with billing and reimbursement regulations. Participates in other areas of the Saint Alphonsus Health System Integrity and Compliance Program as directed by the System Integrity and Compliance Officer. Ability to act independently with proven leadership skills. Excellent communication and organizational skills. Colleagues of Saint Alphonsus Health System enjoy competitive compensation with a full benefits package and opportunity for growth throughout SAHS and Trinity Health. Visit www.saintalphonsus.org/careers to learn more about the benefits, culture and career development opportunities available to you at Saint Alphonsus Health System. Saint Alphonsus and Trinity Health are committed to promoting diversity in its workforce and to providing an inclusive work environment where everyone is treated with fairness, dignity and respect. We are committed to recruit and retain a diverse staff reflective of the communities we serve. Saint Alphonsus and Trinity Health are equal opportunity employers and prohibit discrimination against any individual with regard to race, color, religion, gender, marital status, national origin, age, disability, sexual orientation, or any other characteristic protected by law. Our Commitment to Diversity and Inclusion Trinity Health is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians across 25 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions. Our dedication to diversity includes a unified workforce (through training and education, recruitment, retention, and development), commitment and accountability, communication, community partnerships, and supplier diversity. Trinity Health is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians across 25 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions. Based in Livonia, Mich., and with annual operating revenues of $17.6 billion and assets of $24.7 billion, the organization returns $1.1 billion to its communities annually in the form of charity care and other community benefit programs. Committed to those who are poor and underserved in its communities, Trinity Health is known for its focus on the country's aging population. As a single, unified ministry, the organization is the innovator of Senior Emergency Departments, the largest not-for-profit provider of home health care services — ranked by number of visits — in the nation, as well as the nation’s leading provider of PACE (Program of All Inclusive Care for the Elderly) based on the number of available programs. For more information, visit www.trinity-health.org. You can also follow @TrinityHealthMI on Twitter.

Salary : $18 - $25