Revenue Integrity Clinical Specialist

At St. Tammany Health System, delivering world-class healthcare close to home is our goal. That means we are committed to attracting and retaining the very best professionals for every position in our health system.

We believe the pristine beauty of St. Tammany Parish adds to our attractive compensation package. The health system is nestled in the heart of Covington on the north shore of Lake Pontchartrain. It is a peaceful, scenic, community-oriented area with an abundance of amenities to suit every taste.

WORK SHIFT: Part-time (Monday thru Friday) 8:00am - 4:30pm, rotating schedule

JOB SUMMARY: 

Provides support to the Revenue Cycle Integrity department by analyzing, researching, and resolving issues related to operational process improvement/efficiencies and revenue optimization.

MINIMUM QUALIFICATIONS:

• Three years of clinical experience as a Registered Nurse, including at least one year performing utilization review, chart audit, case management, or similar functions in an acute care hospital required
• Nursing licensure required; medical coding or auditing certification preferred
• Completion of coursework from an accredited college or university leading to an associate’s degree in nursing required
• Bachelor’s degree in nursing preferred
• Experience in hospital revenue cycle preferred
• Strong analytical/critical thinking and presentation skills
• Solid computer and system skills including a working knowledge of Microsoft Office products with experience in MS Excel and Word
• Self-motivated with the ability to work in a dynamic, fast-paced environment
• Excellent organizational skills

Knowledge of:

• Typical nursing practices within an acute care hospital
• Medical terminology, including common diseases, conditions, and treatments
• Provider side of the healthcare industry with an understanding of ICD10, DRG, CPT4 codes, and UB-04 data elements
• Standard reimbursement and insurance practices common to health care industry pertaining to both hospital managed care and government contracts
• Applicable laws, regulations, requirements, standards, and practices pertaining to patient confidentiality and information management

Ability to:

• Read and understand patient medical records and other treatment documentation; interpret medical provider notes and comments, including the use of common acronyms and abbreviations
• Identify discrepancies between medical information and billed charges
• Understand, interpret, and apply laws, rules, regulations, and policies related to patient accounting, billing, collections, and general hospital administration
• Collect, interpret, and evaluate narrative and statistical data pertaining to administrative, fiscal management, and patient matters; prepare complex reports, memoranda, and other written materials
• Utilize standard business equipment, including computer hardware and software
• Analyze and resolve problems and complaints
• Communicate clearly and effectively both verbally and written
• Establish and maintain cooperative working relationships with internal customers, managed care entities, and other health care industry personnel
• Provide excellent public relations and courteous customer service
• Work cooperatively with others and have a positive, willing attitude
• Focus on detail and multi-task
• Maintain a professional and neat work environment

PHYSICAL DEMANDS:

Must possess good physical health.  Some requirements include but are not limited to standing, sitting or walking for long periods of time.  Lifting at least 20 pounds is required.  
Physical Effort required:              

Constant (67%-100%) – talking, hearing, seeing
Frequently (34%-66%) - handling/feeling
Occasionally (1%-33%) – lifting, carrying, pushing/pulling, stooping, climbing (stairs, ladders, etc) balancing, crouching, reaching

EMPLOYMENT

Each St. Tammany Health System staff member is expected to conduct himself or herself according to our mission, vision and values. Please take time to review those expectations, which can be found by clicking here, before applying for employment. If you feel you are unable to demonstrate those characteristics, we respectfully request that you do not proceed with the application process.

EQUAL OPPORTUNITY EMPLOYER

St. Tammany Health System is an Equal Opportunity Employer. St. Tammany Health System is committed to equal employment opportunity for all employees and applicants without regard to race, color, religion, sex, age, national origin or ancestry, citizenship, sexual orientation, gender identity, veteran status, disability status, genetic information or any other protected characteristic under applicable law.