Revenue Integrity Analyst Sr

Department

Revenue Cycle

This position partners with various departmental staff and physicians:
Patient Financial Services (PFS), Case Management (ICM), Health Information Management (HIM), Corporate Compliance, Surgery, Nursing, Physicians, Outpatient Procedural Departments, Reimbursement, and Internal Audit. Serves as a primary resource and educator to these departments for appropriate patient status, charge capture, coding, billing, medical necessity, Medicare rules, and payment methodologies. Leads and participates in various Revenue Cycle committees, appeals processes, and contributes to changes which improve overall compliance and improve revenue recognition.

The primary goal of this position is to improve the performance of the Revenue Cycle processes including developing best practices, clinical documentation, coordinating issue resolution, and establishing proactive prevention measures. This position provides excellent customer service and has a high degree of autonomy.

• Require coding certification from the American Health Information Management Association or American Academy of Professional Coders within one (1) year of hire date.
• Require a minimum of three (3) years of strong training and background in coding and reimbursement.
• Require demonstrated knowledge of Medicare, Medicaid, Medicare OPPS reimbursement and third party billing rules and coverage.
• Require demonstrated knowledge of medical necessity rules and Medicare inpatient only list.

• Prefer previous auditing experience.
• Prefer demonstrated proficiency in verbal and written communication.
• Prefer demonstrated ability to relate well to others in a variety of functional areas, handle multiple responsibilities simultaneously and to problem-solve and think both creatively and analytically.

BD:
Bachelor Degree

MBA:
Master of Business Admin

Sarasota Memorial Hospital was recently recognized again by ranking #1 Hospital in the Region by the "U.S. News's Best Hospital report" by scoring a Perfect 10! Not only that, but SMH was also designated at a national "standout" hospital for earning top ratings in all evaluated conditions and procedures - an accomplishment achieved by less than 1% of the 4000+ hospitals.

Our system has also earned Magnet® recognition from the American Nurses Credentialing Center (ANCC), as well as these additional accolades:
Gallup Great Workplace 2018; recipient of an "A" grade for Patient Safety. Sarasota Memorial Hospital is Magnet designated and the only provider of Level II trauma services, obstetrical services, and Level III neonatal intensive care in Sarasota County.

Every day, our patients at Sarasota Memorial Health Care System receive a first-class experience in care from a team on a mission to deliver the highest level of care in America. In the process of rising to that challenge, one by one, our people are finding their purpose and feeling their impact. Now it is your turn to see yourself here.

• 5
  - Star Quality Rating
  - SMH
  - Sarasota is the only hospital in Florida to earn the federal Centers for Medicare & Medicaid Services highest rating every year since its inception.
• 50 Best Hospitals
  - SMH ranked among U.S. News & World Report's 50 Best Hospitals in two specialties, Rehabilitation and Obstetrics/Gynecology in , and among the nation's top 10% high performers in 18 other medical specialties, procedures and conditions.
• World's Best Hospitals
  - SMH
  - Sarasota has made Newsweek's prestigious list six years in a row, since the global rankings began in 2019.
• A  for Patient Safety
  - SMH
  - Sarasota has earned straight A's since it began…