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Day - 08 Hour (United States of America)

This is a Stanford Health Care - University Healthcare Alliance job.

A Brief Overview
The revenue integrity integration analyst will join a highly integrated, rapid and project-based team that supports the Stanford Medicine Partner Physician Foundation, Stanford Healthcare Enterprise. The analyst supports Epic set up for billing of new onboarding clinics and clinicians. For new clinics or clinicians with legacy systems, the analyst will perform a deep dive into the legacy system around scheduling and billing workflow to support the transition and integration of billing into the Epic. Examples of support includes but not limited to monitoring of charges to ensure appropriate documentation, coding, billing, routing and processing.

The analyst will support troubleshooting and optimization of billing related system issues and opportunities which includes but not limited to optimizing clinical workflow to meet billing compliance requirements, work with Epic TDS teams to implement system optimizations, charge reconciliation or updates. Analyst will support the needs of the dept, clinics and revenue cycle teams.

Locations
Stanford Health Care - University Healthcare Alliance

What you will do

• Integration Analyst I:
• New clinics or clinicians ensures stabilization and successful transition to SHC Revenue Cycle with 60 days or specific timeframe dependent on the specialty.
• Identifies issues during stabilization that require escalation to Supervisor and/or Sr. Manager.
• Collaborates with SHC Revenue Cycle on the revenue cycle handoff from REACT.
• Partners with SHC Revenue Integrity teams with Supervisor and Sr. Manager through SHC Coding and Charge Capture escalations.
• Collaborates with the Digital Solution team on Epic build and optimization.
• Resource to providers, clinic leadership and clinical staff for inquiries or education requirements/guidelines requests.
• Participates in projects: (Example) Electronic Charge Capture optimization to identify and transition manual charge entry practices into an automated charge workflow through Epic.
• Actively participates in meetings and/or seminars and disseminates the information to peers to enhance the knowledge and skills of the department.
• Other duties as assigned.
• Communication & Documentation:
• Keeps abreast of current changes in coding and reimbursement requirements for government programs and other third party payers.
• Timely and accurate reporting to management, Department Performance Goals and Objectives.
• All other duties as assigned including department-specific functions and responsibilities:
• Effectively utilize ICD-10, CPT/HCPCS and related materials to investigate coding issues and produce accurate results.
• Understands Medicare billing rules (i.e. LCD/NCD, CCI, Medical Necessity, and ABN) and communicates this information to staff, management and physicians.
• Assures compliance with coding rules and regulations according to regulatory agencies, as well as company and applicable professional standards.
• Conducts system testing, provides feedback, and supports conversions/implementations on coding and charge entry issues.
• Evaluates and implements processes to ensure accurate reimbursement.
• Adheres to safety, P4P's (if applicable), HIPAA and compliance policies.
• Provides orientation and training to staff as assigned.
• Performs other duties as assigned and participates in organization projects as assigned.

Education Qualifications

• High school diploma or GED equivalent.
• Multi-Specialty Certification through AAPC or AHIMA preferred.

Experience Qualifications

• Minimum of 2 years' experience in healthcare setting within an office-based healthcare physician practice a plus.
• 2+ years of expert knowledge of professional revenue cycle billing and processes.
• 2+ years of inter-technical understanding of Electronic Medical Record System (EMR) within the clinical and revenue cycle modules.
• Experience with Epic and other full EMR systems preferred.
• Multi-specialty coding and/or auditing and strong knowledge of healthcare compliance preferred.

Required Knowledge, Skills and Abilities

• Demonstrated knowledge of medical coding (including CPT4, HCPCs, ICD-9), with EMR experience. Knowledge of Medicare, Medi-Cal, commercial and managed care insurance required.
• Extensive knowledge of Epic EMR build specific to billing and charge related function and items.
• Strong computer skills including experience working with the following: Microsoft Office Suite (Word, Excel, PowerPoint), databases, graphics, and presentation software, electronic calendar and email.
• Ability to work independently with excellent follow-through and maintain confidentiality as required.
• Demonstrated ability to access state and federal websites for coding, billing, and reimbursement information.
• Strong verbal/written communication and listening skills; including excellent interpersonal skills and telephone communication. Ability to maintain patient and employee confidentiality.
• Experience developing and implementing training programs.
• Ability to maintain composure during challenging interpersonal interactions.
• Ability to effectively organize and prioritize tasks in order to complete assignments within the time allotted.
• Ability to work with others in a flexible, cooperative manner.

Licenses and Certifications

Physical Demands and Work Conditions

Physical Demands

• Constant Sitting.
• Frequent Walking.
• Occasional Standing.
• Occasional Bending.
• Occasional Squatting.
• Occasional Climbing.
• Occasional Kneeling.
• Seldom Crawling.
• Constant Hand Use.
• Constant Repetitive Motion Hand Use.
• Frequent Grasping.
• Occasional Fine Manipulation.
• Frequent Pushing and Pulling.
• Occasional Reaching (above shoulder level).
• Frequent Twisting and Turning (Neck and Waist).
• Constant Vision (Color, Peripheral, Distance, Focus).

Lifting

• Frequent lifting of 0 - 10 lbs.
• Occasional lifting of 11 - 20 lbs.
• Seldom lifting of 21 - 30 lbs.
• Seldom lifting of 31 - 40 lbs.
• Seldom lifting of 40+ lbs.

Carrying

• Frequent lifting of 0 - 10 lbs.
• Occasional lifting of 11 - 20 lbs.
• Seldom lifting of 21 - 30 lbs.
• Seldom lifting of 31 - 40 lbs.
• Seldom lifting of 40+ lbs.

Working Environment

• Occasional Driving cars, trucks, forklifts and other equipment. May be required to drive personal vehicle to sites.
• Constant Working around equipment and machinery. Office equipment (computers, phones, fax, copy machines, printers, 10-key, etc.).
• Seldom Walking on uneven ground.
• Seldom Exposure to excessive noise.
• Seldom Exposure to extremes in temperature, humidity or wetness.
• Seldom Exposure to dust, gas, fumes or chemicals.
• Seldom Working at heights.
• Seldom Operation of foot controls or repetitive foot movement.
• Seldom Use of special visual or auditory protective equipment.
• Seldom Use of respirator.
• Seldom Working with biohazards such as blood borne pathogens, hospital waste, etc..

Blood Borne Pathogens

• Category III - Tasks that involve NO exposure to blood, body fluids or tissues, and Category I tasks that are not a condition of employment

Travel Requirements

• 10% travel:

These principles apply to ALL employees:

SHC Commitment to Providing an Exceptional Patient & Family Experience

Stanford Health Care sets a high standard for delivering value and an exceptional experience for our patients and families. Candidates for employment and existing employees must adopt and execute C-I-CARE standards for all of patients, families and towards each other. C-I-CARE is the foundation of Stanford's patient-experience and represents a framework for patient-centered interactions. Simply put, we do what it takes to enable and empower patients and families to focus on health, healing and recovery.

You will do this by executing against our three experience pillars, from the patient and family's perspective:

• Know Me: Anticipate my needs and status to deliver effective care
• Show Me the Way: Guide and prompt my actions to arrive at better outcomes and better health
• Coordinate for Me: Own the complexity of my care through coordination

Equal Opportunity Employer Stanford Health Care (SHC) strongly values diversity and is committed to equal opportunity and non-discrimination in all of its policies and practices, including the area of employment. Accordingly, SHC does not discriminate against any person on the basis of race, color, sex, sexual orientation or gender identity and/or expression, religion, age, national or ethnic origin, political beliefs, marital status, medical condition, genetic information, veteran status, or disability, or the perception of any of the above. People of all genders, members of all racial and ethnic groups, people with disabilities, and veterans are encouraged to apply. Qualified applicants with criminal convictions will be considered after an individualized assessment of the conviction and the job requirements.

Base Pay Scale: Generally starting at $35.25 - $44.95 per hour

The salary of the finalist selected for this role will be set based on a variety of factors, including but not limited to, internal equity, experience, education, specialty and training. This pay scale is not a promise of a particular wage.