When you join the team at SSM Health, you are accepting more than a job. It’s more than a career. It’s a sacred trust in a health care organization rich in a heritage of healing that began more than 140 years ago.
At SSM Health, we are driven by our Mission. It compels us to provide the safest, highest-quality care and service for our patients and customers. Our Mission empowers us to be exceptional.
We are transforming SSM Health to better support our integrated health care delivery model. We are focused on building a healthier lifestyle for our patients, employees, physicians and customers. We are doing some exceptional work here at SSM Health — and we need exceptional people, like you, to live out our Mission and Values.
The employees of SSM Health are truly our greatest resource — and we are committed to helping them continue to develop and grow personally and professionally. When team members excel , so does our healing Mission.
Under general supervision of the Government Audit Department Team Leader, the Regulatory Auditor reviews a wide range of government audit denials. The primary role of the Regulatory Auditor is to review denials and appeal those which are found to be unsubstantiated through review of the medical record and/or billing information. The Regulatory Auditor is responsible for tracking assigned cases and data entry of audit related information into SSM’s web-based audit tracking tool. Through analysis and interpretation of audit findings, the Regulatory Auditor supports staff education, quality improvement, policy development, and overall improvement of financial performance.
Preference will be shown for candidates with a strong working knowledge of coding practices and regulations, possessing a Certified Coding Specialist (CCS) certification
Needs experience in clinical documentation improvement (ex. Clinical Documentation Specialist), possessing one or more of the following credentials: CDIP, CCDS is desired. Additionally, previous healthcare compliance experience, with knowledge of the revenue cycle and regulatory environment is desired.
Strong attention to detail and highly developed analytical skills enabling review and comprehension of complex audit denials. Ability to research, interpret and apply healthcare rules and regulations as they pertain to incoming audit denials. Ability to communicate complex Medicare guidelines to key stakeholders. Exceptional letter writing skills required for composition of accurate, thorough and clear appeal letters. Solid working knowledge of Microsoft Excel and Word. Ability to navigate multiple PC-based systems, as well as SSM’s financial and electronic health record systems. Ability to run, export, and analyze reports using the organization’s audit tracking tool. Must work well under pressure, organizing workload and prioritizing tasks effectively, while meeting multiple and sometimes competing deadlines.