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.

We are looking for a new Revenue Integrity Auditor to join our team, working in coordination with Revenue Liaison and Revenue Integrity, monitoring revenue cycle operations. This will include but is not limited to: regulatory reviews, audit reviews of pre-service, time of service and post service revenue cycle.

GENERAL SUMMARY AND PURPOSE:

Conducts detailed audits of charges to ensure that documentation supports billing and is in compliance with documentation, and applicable policies, procedures and regulations. Directly responsible for monitoring and analyzing charging policies and practices for all hospital departments and applying and communicating that knowledge to both clinical and non-clinical management in order to facilitate correct and compliant charging and optimize reimbursement.. Communicates all audit findings with necessary parties. Analyzes and identifies breakdowns in processes that have financial impacts and coordinates appropriate work groups to resolve the issues Assists with compliance, education, accuracy in charge capture and improvement in the revenue cycle processes as identified through revenue cycle audits. Completes assigned reports timely and accurately. May be required to travel between health system sites.

SKILLS, KNOWLEDGE, EDUCATION AND EXPERIENCE:

Bachelors degree in Business preferred, or related field or equivalent experience/specialized education in hospital revenue cycle operations.
RHIA/RHIT, CPC, CCS or equivalent coding certification(s) preferred.
Three years experience in health care reimbursement or hospital business office operations.
Strong preference for knowledge of Medicare coding and reimbursement systems for inpatient and outpatient hospital services, including CPT and HCPCS coding gained through experience.

ESSENTIAL FUNCTIONS:

Knows, understands, incorporates, and demonstrates the Organizations Mission, Vision, and Values in behaviors, practices, and decisions.
Conducts departmental audits to ensure proper documentation and compliance with state and federal guidelines relating to the charge capture and billing of services. Prepares and submits audit findings and makes recommendations to Revenue Integrity and Compliance. Coordinates concurrent and retrospective audits of patient medical records and itemized bills
Performs charge audits to ensure charging/coding accuracy provides feedback to department Revenue Leads and Management.
Must possess a demonstrated knowledge of clinical processes, charge master maintenance, clinical coding (CPT, HCPCS, ICD-9/10, revenue codes and modifiers), charging processes and audits, and clinical billing.
Reviews bulletins to maintain an understanding of regulatory and payer changes to assure correct charging and billing requirements are met.
Maintains working knowledge of coding and billing regulations for all payors. Keeps current on regulatory updates.
Maintains working knowledge of local established policies, protocols, and procedures to ensure charge accuracy
Provides results and education to department managers and charge capture auditors.
Proficient in outpatient and inpatient charge capture operations and coding
Comprehension of revenue cycle operations
Maintains a positive relationships with all parties
Willingness to adjust competencies as necessary to meet requirements of position.
Ability to work with a wide variety of people under adverse conditions.
Strong communication skills.
Knowledge of charge capture, reconciliation, error management operations required.
Attends required training sessions on updates to billing regulations and/or charge capture process.
Proficient in use of MS Office applications (Word, Excel), Internet applications and Outlook
Excellent communication and organizational skills

Highlights and Benefits:

When Saint Alphonsus takes care of you, you can take better care of our patients. We foster personal and professional growth and offer opportunities that empower our colleagues to develop their careers. Our belief in work-life balance compliments the natural beauty, diverse landscapes, and outdoor recreation lifestyle that is unique to Idaho and Oregon.

We offer market-competitive pay, generous PTO, and multiple options for comprehensive benefits that begin on day one.
Benefits for your future include retirement planning and matching, college savings plans for your family, and multiple life insurance plans that can change as your needs develop.
We are proud to offer Employee Assistance Programs, tuition reimbursement, and educational opportunities to help you learn and grow.

Ministry/Facility Information:

Saint Alphonsus Health System is a faith-based ministry and not-for-profit health system serving Idaho, Oregon, and northern Nevada communities. The health system boasts 4 hospitals, 609 licensed beds, and 73 clinic locations. Through innovative technologies, compassionate staff, and healing environments, Saint Alphonsus goal is to improve the health and well-being of people by emphasizing care that is patient-centered, physician-led, innovative, and community-based.

Top 15 Health Systems in the country by IBM Watson Health;
The region’s most advanced Trauma Center (Level II);
Commission on Cancer Accredited Program through demonstrating an uncompromising commitment to improving patient survival and quality of life

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 one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law.