SR Compliance, Audit and Reimbursement Specialist

Job Description

Job ID: 1187095
Employment Status: Full-Time
Your Career. Made Better.

BJC HealthCare is one of the largest nonprofit health care organizations in the United States, delivering services to residents primarily in the greater St. Louis, southern Illinois and mid-Missouri regions. BJC serves patients and their families in urban, suburban and rural communities through its 15 hospitals and multiple community health locations. Services include inpatient and outpatient care, primary care, community health and wellness, workplace health, home health, community mental health, rehabilitation, long-term care and hospice.


Join Us!


Role Purpose

Responsible for developing, coordinating and performing all components of compliance audit reviews for the HSO. The duties include, but are not limited to coordinating and scheduling audits, assessing the environment and developing the appropriate audit methodology, facilitating sessions with control owners, documenting processes using flowcharts, narratives, and other appropriate tools and the respective internal controls, performing detailed audit procedures to validate key internal controls are in place and functioning appropriately and assessing results, and communicating audit findings to management at all levels and assisting management in developing appropriate action plans and monitoring procedures/tools.


Responsibilities

  • Plans, schedules, and conducts billing audits.
  • Identifies potential organizational risk, analyzes data, designs and produces audit plans to measure risk. Interprets audit results, and recommends corrective action plans to decrease risk.
  • Designs, implements and tests management dashboard indicators and troubleshoots other existing reports.
  • Communicates with internal and external associates to address concerns regarding trial billing related issues.

  • Minimum Requirements

     

    Degree

  • Associate's Degree
  •  

    Experience

  • 2-5 years
  •  

    Supervisor Experience

  • No Experience

  •  

    Preferred Requirements and Additional Job Information

     

    Degree

  • Bachelor's Degree
  • - Bus/HC Admin/Nursing/related

     

    Experience

  • 5-10 years
  •  

    Supervisor Experience

  • < 2 years
  •  

    Licenses & Certifications

  • RN
  • RHIA/RHIT/CCS

  • Benefits Statement

    Note: not all benefits apply to all openings

    -  Comprehensive medical, dental, life insurance, and disability plan options
    -  Pension Plan*/403(b) Plan
    -  401(k) plan
    -  Tuition Assistance
    -  Health Care and Dependent Care Reimbursement Accounts
    -  On-Site Fitness Center (depending on location)
    -  Paid Time Off Program for vacation, holiday and sick time

    *Pension does not apply to Memorial Hospital, Memorial Hospital East, Memorial Medical Group, Alton Memorial or Parkland Health Center


    Legal Statement

    The above information on this description has been designed to indicate the general nature and level of work performed by employees in this position. It is not designed to contain or be interpreted as an exhaustive list of all responsibilities, duties and qualifications required of employees assigned to this job.

     

    Equal Opportunity Employer