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Payer Integrity Coordinator

Company:
SCL Health
Location:
Broomfield, CO
Post Date:
November 18, 2021
Job Status:
Full-Time
Description:

You.

 

You bring your body, mind, heart and spirit to your work as a Payer Integrity Coordinator.  

 

You know when to move quickly. When to sit quietly. When to laugh loudly.

 

Youre great at what you do, but you want to be part of something even greater. Because you believe that while individuals can be strong, the right team is invincible.

 

Us.

 

System Service: is our Corporate Headquarters in Broomfield, Colorado and is located within the Oracle campus. SCL Health is a faith-based, nonprofit healthcare organization dedicated to improving the well-being of the people we serve.

 

Benefits are one of the ways we encourage health for you and your family. Our generous package includes medical, dental and vision coverage. But health is more than a well-working body: it encompasses body, mind and social well-being. To that end, weve launched a Healthy Living program to address your holistic health. Healthy Living includes financial incentives, digital tools, tobacco cessation, classes, counseling and paid time off. We also offer financial wellness tools and retirement planning.

 

We.

 

Together well align mission and careers, values and workplace. Well encourage joy and take pride in our integrity.

 

Well laugh at each others jokes (even the bad ones). Well hello and high five. Well celebrate milestones and acknowledge the value of spirituality in healing.

 

Were proud of what we know, which includes how much there is to learn.

 

Your day

 

As a Payer Integrity Coordinator you need to know how to:

 
     
  • Review payer plans and partners with Managed Care to clarify the meaning and impact of those changes. Collaborates on a daily basis with charge capture, chargemaster, audits, appeals, claim edits and Revenue Practice Team areas.
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  • Collaborate with operational areas including Revenue Practice Teams, Finance, Managed Care, clinical operations, IT, EL&PD (Education) and Billing to operationalize changes and monitor communications.
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  • Review government and commercial payer changes and updates to identify the caresite and system-supported areas impacted by those changes. Perform or direct a financial analysis and communicates the financial impact projections to leadership.
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  • Ensure revenue cycle operations and Epic (CDM, Willow, Workqueues, Charge Route, etc) support accurate claim submission based on payer policies. This includes changes of chargemaster fee schedules and pharmaceuticals for the hospital and medical group. Understands and identifies MRP plans that follow Medicare rules specific claims submission requirements.
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  • Collaborate with SCL areas (Finance, Managed Care, etc.) to provide insight of payer agreed rate increases, pricing strategy decisions and timing, compliance with ongoing Price Transparency initiatives, chargemaster changes and maintenance, annual price updates and pricing changes made throughout the year.
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  • Provide recommended language and topics of opportunity in Revenue Integrity prior to the execution and renewal of payer contracts. These may include fee schedules, exclusions/inclusion, the practice and number of allowed payer audits, appeals and administrative process improvements. Provides proactive and ongoing feedback to potential payer policy changes to mitigate impact to revenue and administrative burden through JOC and Managed Care forums.
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Your experience

 

We hire people, not resumes. But we also expect excellence, which is why we require:

 

Required:

 
     
  • Bachelors Degree in Healthcare Administration field or business related field, required.
  •  
  • Certified Professional Coder (CPC), Registered Health Information Professional (RHIT), Certified Outpatient Coder (COC), Certified Coding Specialist (CCS), Certified Coding Associate (CCA), or currently enrolled in a coding certificate program that must be completed within 9 months of employment is required.
  •  
  • Epic HB Billing certified (chargemaster focus) is preferred.
  •  
 

Your next move

 

Now that you know more about our team we hope youll join us. At SCL Health youll reaffirm every day how much you love this work, and why you were called to it in the first place.

 

Will consider a 100% remote associate

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