Surgical Services Analytics Coordinator - CommonSpirit Health

CHI Saint Joseph Health is one of the largest and most comprehensive health systems in the Commonwealth of Kentucky supporting over 5,000 active employees, 8 hospitals, and a Medical Group with more than 200 locations across Central and Eastern Kentucky.  

At CHI Saint Joseph Health, we are dedicated to building healthier communities by elevating patient care through high quality healthcare professionals andHumankindness.  We are guided by our strong mission and faith-based heritage, and we're dedicated to providing you with the same level of care you provide to others.  We care about our team members well-being and offer benefits that complement work/life balance such as: 

• Paid Time Off (PTO)
• 401(k) and 457(b) Retirement Programs with matching
• Medical/Dental/Vision Insurance
• Mental Health resources for you and your family
• Wellness Program with rewards up to $450
• Tuition Reimbursement for future career growth and development
• Adoption Assistance
• Voluntary Protection: Accident, Critical Illness, Identify Theft and Pet Insurance
• Short and Long Term Disability 
• Free Premium Membership to Care.com with preloaded credits to support adult and child care needs
• Employer Discounts
• Relocation Assistance*

*for eligible hires

Learn more about our awards and recognitions here:CHI Saint Joseph Health

CHI Saint Joseph Health is part of CommonSpirit Health, a nonprofit, Catholic health system dedicated to advancing health for all people. CommonSpirit Health was formed by the alignment of Catholic Health Initiatives (CHI) and Dignity Health in 2019. With our combined resources, CommonSpirit is committed to building healthy communities, advocating for those who are poor and vulnerable, and innovating how and where healing can happen, both inside our hospitals and out in the community.  Learn more aboutCommonSpirit Health here.

JOB SUMMARY / PURPOSE
The nature of “coordinator” responsibilities may vary slightly depending on the core job, but generally involves oversight of various activities involved with market surgical services Revenue Cycle analytics. An incumbent performs much the same work as others in the job family, through participation in the dayto-day operations of the work unit, with “coordinator” work. Knowledge of the policies, procedures and equipment applicable to the work unit is required.

ESSENTIAL KEY JOB RESPONSIBILITIES
This job is responsible for performing Revenue Cycle analytic functions in accordance with applicable guidelines. An incumbent serves as a liaison between employed and nonemployed Provider Clinics, Revenue Cycle, and other departments on questions regarding assigned market surgical services Revenue Cycle analytic functions. In addition, an incumbent is responsible for assisting the Market Manager of Surgical Services Analytics with daily tasks as assigned which may include reporting, auditing, training, researching, and creating standard operating procedures etc. according to proper surgery Revenue Cycle guidelines. Daily Work requires critical thinking skills, attention to detail, the ability to accurately and timely troubleshoot/resolve questions/issues and to resolve (within scope of the position) issues which may have a potential impact on market surgical services revenues. 

• Serves as a “coordinator” resource for other staff in their assigned functional unit and assists the Manager through the transmission of work instructions and participation in the planning, development, and implementation of new/revised procedures.
• Reviews work to facilitate efficient workflows; assists Manager with staff orientation/training; and provides feedback on Revenue Cycle performance as requested.
• Troubleshoots and resolves (within the scope of this position) more complex problems and/or issues received from other staff members. Receives and responds in a timely and professional manner to all assigned functional area questions posed by team members and leaders; serves as liaison with various employed and nonemployed provider clinics, revenue cycle, and other departments to respond to, or initiate response.
• Responds to emails and calls from team members/leaders in an organized, accurate and timely manner.
• Explains various Revenue Cycle issues affecting reimbursement, including authorizations, insurance, reimbursement methodology, and denial trends.
• Applies knowledge of CMS and other insurance billing guidelines and regulations, payer contracts and reimbursement as well as experience with insurance review to gather additional information, as necessary. Identifies and researches unusual, complex or escalated issues as assigned; applies problem-solving and critical thinking skills as necessary to resolve issues within the scope of position authority. Collaborates with employed and nonemployed Provider Clinics, Revenue Cycle team members, and other departments.
• Identifies trends in market surgical services Revenue Cycle analytics, including: denials and billing issues, and identifies resolutions in accordance with established guidelines.
• Notifies Market Manager, Surgical Services Analytics of other ongoing issues and concerns.
• Documents all activities and findings in accordance with established policies and procedures ensures the integrity of all account documentation and written responses to market surgical services Revenue Cycle analytics issues; maintains confidentiality of medical records. Maintains current knowledge of internal, payer, and government regulations as applicable to assigned function.
• Explains challenging escalated requests to all involved.
• Has knowledge of, and is compliant with, government regulations requirements, compliance program, HIPAA, etc.
• Establishes and maintains professional and effective relationships with peers and other stakeholders.
• Works collaboratively with employed and nonemployed Provider Clinics, Revenue Cycle team members, and other departments to explain market surgical services Revenue Cycle issues.
• Establishes and maintains a professional relationship with employed and nonemployed Provider Clinics, Revenue Cycle team members, and other departments in order to resolve issues.
• Maintains professional telephone and e-mail communications.
• Depending on the role and the level of Epic training, this position may be called upon to support other areas in market surgical services Revenue Cycle functions.
• Communicate audit and production standards and reviews to Revenue Cycle staff to improve proper handling of accounts.

The job summary and responsibilities listed above are designed to indicate the general nature of the work performed within this job. They are not designed to contain or be interpreted as a comprehensive inventory of all job responsibilities required of employees assigned to this job. Employees may be required to perform other duties as assigned.

MINIMUM QUALIFICATIONS

• Required Education and Experience:
  • High school diploma or equivalent
• Preferred Education and Experience:
  • 2 years of Surgical Services Revenue Cycle experience
• Required Licensure and Certifications:
  • N/A
• Required Minimum Knowledge, Skills,Abilities, and Training:
  • Knowledge of medical insurance, CPT and ICD codes.
  • Knowledge of general office principles, practices, standards, systems and tools/equipment. 
  • Knowledge of medical insurance, payer contract, and basic medical terminology and abbreviations.
  • Knowledge of the regulatory/reporting requirements that pertain to the assigned function.
  • Knowledge of sources and availability of information relevant to the assigned function.
  • Knowledge of the operation and application of automated systems applicable to the assigned function.
  • Ability to enter data in accordance with established standards of timeliness, accuracy and productivity.
  • Ability to understand and apply detailed billing requirements and insurance follow-up practices.
  • Ability to keep abreast of trends, developments and changing regulatory requirements that impact matters within designated scope of responsibility.
  • Ability to identify and articulate non-compliance with established guidelines and/or regulatory requirements.
  • Ability to troubleshoot, understand and/or adapt moderately complex oral and or written instructions/guidelines to diverse or dissimilar situations.
  • Ability to maintain confidentiality of medical records, and to use discretion with confidential data and sensitive information.
  • Ability to demonstrate attention to detail and critical thinking skills within the context of the assigned function, with a commitment to accuracy.
  • Ability to effectively prioritize and execute tasks while under pressure.
  • Ability to make decisions based on available information and within the scope of authority of the position.
  • Ability to demonstrate excellent customer service skills,including professional telephone interactions.
  • Ability to read, understand and communicate in English sufficient to perform the duties of the position.
  • Ability to establish and maintain effective working relationships as required by the duties of the position.
  • Ability to use office equipment and automated systems/applications/software at an acceptable level of proficiency.