INTEGRIS Health

Medical Billing and Coding

• Analyzes relevant clinical and demographic information from the Health Information record
• Assigns appropriate ICD-10 and CPT codes following appropriate guidelines
• Ascertains compliance with CMS, state, and other regulatory agencies
• Provides mentorship and training to on-boarding coders
• Completes analysis of documentation and code assignment
• Coordinates documentation needs and query follow-up with the Clinical Documentation Specialist
• Reviews provider documentation for coding appropriateness
• Assigns diagnosis and procedure codes for various medical services

Senior Certified Coding Specialist – Surgical Coding

• Completes analysis of documentation, abstracting and code assignment by body system, organ, etiology and morphology according to the American Hospital Association Official ICD-10 Coding Guidelines (Coding Clinic), ICD-10-CM, CPT4/HCPCS Coding Guidelines, ASC groups, UHDDS Guidelines, HCFA methodology guidelines for coding, state and federal guidelines and hospital abstracting guidelines
• Performs queries and obtains documentation required for coding
• Responsible for maintaining current knowledge of coding guidelines and relevant federal regulations through the use of ICD-10, CPT and HCPCS materials
• Answers customer calls
• Demonstrates basic knowledge of revenue cycle

Certified Coding Specialist – HB Outpatient Coding

ServiceNow

• Supporting application implementations, upgrades, and ongoing maintenance activities
• Supporting Technology Governance, the Project Management Lifecycle, Service Transition and Service Operations

Applications Analyst – ServiceNow, CMDB

Director

• Implements and oversees INTEGRIS Health metro and rural payor contracting strategies, including on-going analysis and review of financial performance
• Develops and implements common policies and procedures for Contracting departments
• Ensures department staffs are managed effectively to insure that Contracting activities for all INTEGRIS Health facilities meets the INTEGRIS Health system goals of Operational, Clinical and Service excellence
• Leads contract negotiations with payers on behalf of INTEGRIS Health owned hospitals and employed physicians, including INTEGRIS Health affiliated physicians and joint-venture partnerships for all Commercial, Medicare Advantage, Managed Medicaid and Marketplace products.
• Responsible for transitioning a percentage of INTEGRIS Health payer portfolio to value-based contracts while continuing to maximize the terms of INTEGRIS Health's traditional fee-for-service arrangements.
• Will develop strong working relationships with key INTEGRIS Health internal and external stakeholders and will commit to executing the INTEGRIS Health way of maximizing operational performance for the organization.

Director of Contracting – Payor Strategy

Analyst

• Oversees preparation of monthly compensation calculations; reviews models and resolves issues within the models.
• Primary contact for providers, administrative leadership, and other internal and external parties for subjects associated with provider compensation models.
• Communicates provider compensation issues to practice administrators and offer recommendations to implement changes as they occur.
• Prepare specialty compensation related projects and participates in any internal audits related to provider compensation.
• Works on compensation related data needed for strategic plan and annual budget.
• Meets with administrative leadership, providers, and other operational personnel to review compensation models and/or any compensation issues.
• Summarize and analyze provider compensation and productivity data, including market data analyses, interpretation of compensation data, and comparative analysis to industry benchmarks.
• Develop provider compensation models that support the INTEGRIS provider initiative and controlling costs while enhancing provider performance and rewards associated with performance.
• Provide input on target acquisition deal structures to be used in financial proformas.
• Completes special assignments in support of INTEGRIS strategy to retain key provider/practice groups to support the INTEGRIS service line strategy.
• Understand the regulatory environment, mechanics of healthcare reimbursement, entity arrangement types, and overall industry trends and risks.
• Recognize and analyze problems regarding agreements and the conceptual framework for fair market value.
• Completes specialty projects as assigned by the manager of provider compensation.

Provider Compensation Analyst – Days

Infrastructure Engineer

• Serves as an escalation point for Tier 2 Operations team members, working tickets and creating or modifying knowledge base articles.
• Installs and configures systems according to design specifications.
• Assists with analysis, troubleshooting, repairing and performance tuning of complex systems and hardware components.
• Supports the ITIL Service Transition process ensuring new and modified services are appropriately documented and Operations personnel (Service Desk and L2 Operations) are informed and trained.
• Supports testing and evaluation of technologies under review.
• Plans, documents, and implements software patches and upgrades for infrastructure components.
• Actively monitors the environment and appropriately assigns problem tickets, incidents, and schedules reviews to determine support needs for existing and new systems.
• Provides technical support and 24X7 incident response.
• Assists with root cause analysis on failures resulting in downtime or performance outside of service level agreement tolerances.
• Assists with the development and ongoing support of annual infrastructure performance and capacity reports.

Infrastructure Engineer – Unified Communications

Data Engineer

• Performs tasks assignments related to sourcing data and maintaining a stable data platform; solid to intermediate skills level
• Contribute to design, development and implementation of scalable custom solutions that require extensibility either via SSIS or Plugins, APIs, etc.
• Perform tasks and assignments related to bringing new source systems into the data operating System
• Work with team members to build a common understanding of best practices and design principles
• Participate in design and technology review sessions to understand new/deprecated features and their impacts to implementation process along with provide feedback to the technology team
• Manage individual workload and project requirements and timelines
• All other duties as assigned

Manager

• Work PRN Days with our Case Management team providing exceptional care
• Responsible for the clinical and financial outcomes for an assigned caseload of patients
• Facilitate patient care during the hospitalization by managing, coordinating and monitoring resource utilization
• Proactively plan, coordinate and negotiate efficient patient movement throughout the continuum of care
• Function in the role of clinician, educator, researcher, manager and advocate
• Adheres to National Patient Safety Goals as appropriate based on the level of patient contact this position requires

RN Care Manager – PRN Days

• Analyzes relevant clinical and demographic information from the Health Information record
• Assigns appropriate ICD-10 codes following appropriate guidelines
• Ascertains compliance with CMS, state and other regulatory agencies

Certified Coding Specialist – Physician Billing

• Conducts current state analysis of systems and procedures and recommends system design or modifications to achieve desired goals.
• Provides technical support in the evaluation of new financial, clinical, or enterprise systems software products including performance testing, reliability testing, deployment requirements, functional requirements, manpower requirements, and maintainability.
• Analyze specific hardware or software combinations under consideration for use and provide recommendations based on best practice.
• Determines best means to deploy and support products, on a project basis, as they move from the Service Transition to Service Operation.
• Works with design team to test in a structured manner and document results.
• Supports the creation and maintenance of the as-built architectures to support Service Transition and Service Operation.
• Plans, documents, and implements software patches and upgrades for assigned service line.

Applications Analyst – POS

• Responsible for the clinical and financial outcomes for an assigned caseload of patients.
• Facilitates patient care during hospitalization by managing, coordinating and monitoring resource utilization.
• Proactively plans, coordinates and negotiates efficient patient movement throughout the continuum of care.
• Functions in the role of clinician, educator, researcher, manager and advocate.

RN Care Manager – Weekend

• Serves as a senior subject matter expert in revenue integrity, providing advanced analysis, payer escalation support, and leadership for complex revenue cycle issues.
• Leads high-level charge capture initiatives, payer strategy escalations, and systemwide denial prevention efforts.
• Mentors junior analysts, partners with cross-functional leaders, and drives enterprise-wide initiatives that ensure accurate billing, regulatory compliance, and optimized net revenue performance.

Revenue Integrity Analyst III – Pathology

• Assess patient from clinical, social, financial perspective and coordinates post-discharge needs with care team.
• Functions as a clinical and financial resource for patients and interdisciplinary team members.
• Assists in clinical data collection utilizing established criteria and the InterQual system.
• Proactively performs utilization review; communicates coverage; Information with third party payers, medical staff and clinical providers.
• The Case Manager reports to the Director of the Case Management Services.
• The Case Manager meets established deadlines, attends required in-services, maintains staff competencies and completes required documentation; collaborates and works as a team player with all disciplines; presents a professional image to all customers and patients.
• Required to be on call as scheduled by the department.
• Potential exposure to infectious diseases, potential physical danger from disturbed/irate patients and families.
• Emotional stress due to inability to control volume of timing of referrals and necessity to respond to a wide variety of demands and expectations from patients, families, physicians, and other health care professionals.
• Occupational exposure to bloodborne pathogens and other infectious materials as defined by OSHA.
• This position may have additional or varied physical demand and/or respiratory fit test requirements.

RN Care Manager – Days

Accounting Manager

• Responsible for importing and processing of payment files, claim processing, collection of insurance, and/or physician charge entry
• Executes the auditing, denial appeals process, which includes receiving, assessing, documenting, tracking, responding to, and/or resolving appeals with third-party and government payers in a timely manner.
• Monitors payer files for accuracy, ensures payer documentation is completed and assist in updating files with pertinent information as necessary.
• Conducts relevant research to assist with resolving files or claims and to stay informed on best practices and policy reforms.
• Conducts internal and external correspondence accurately, clearly, concisely, and professionally while following organizational regulations.
• Works with internal departments and external organizations to resolve complex accounts.
• Maintains data for trending purposes on payer issues, underpayments, banking errors, payment trends and collaborates with team members to make recommendations for improvements and resolving issues.
• Prepares, maintains, assist with, and submits reports as required.
• Regularly makes complex decisions within the scope of the position, and is comfortable working independently.
• Collaborates with team members to continually improve services, and engages in process and quality improvement activities. Provides feedback to management on revenue opportunities and payer standards.
• Maintains thorough knowledge and can communicate effectively state and federal regulations, accreditation/compliance requirements, and INTEGRIS Health policies, including those regarding fraud and abuse, confidentiality, and HIPAA.
• Pinpoints improvement opportunities and contributes to the testing of system modifications; works closely with IT staff and department managers to ensure proper implementation.
• Participates in professional development to enhance job knowledge and performance.
• Conducts relevant research to assist with completing the appeals process and to stay informed on best practices and policy reforms.

Senior Patient Accounting Specialist - Physician Billing

Solutions Engineer

• supporting and leading enterprise architecture activities that guide the development and management of the health system’s database
• collaborate with stakeholders to understand business needs
• pivotal in shaping projects, products, systems, and services to ensure alignment with business objectives and long-term strategic vision
• translating business and technical requirements into architectural blueprints
• collaborating with product owners to ensure future-proof architecture
• monitoring and identifying deficiencies in the current solution portfolio
• analyzing industry trends and disruptions for informed decision-making
• assisting in product decisions and recommending actions
• consulting on application and infrastructure development projects
• leading evaluation, design, and analysis for solution implementations
• managing and developing architecture for multiple projects
• developing a roadmap for evolving the solution portfolio
• providing consulting support to ensure alignment with enterprise architecture
• installing and maintaining the administrative and monitoring tools for database engines
• building and administering environments for production and non-production needs
• applying upgrades / updates to environments
• responding to emergency and after-hours issues
• presenting recommendations for improvements based on industry experiences and best practices
• documenting measurable outcomes through KPI analysis and impact tracking
• planning and implementing database security policies according to organizational, industry, and vendor standards