Revenue Cycle Regulatory Research Analyst Senior
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AI Summary
It's more than a career, it's a calling
MO-REMOTEWorker Type:
Job Highlights:
Preferred Qualifications: CHC Certification or demonstrated compliance experience and strong analytical ability
Schedule: Full Time. Monday-Friday, 8 hours between 7am - 6pm
Location: Remote - reside in MO, IL, OK, or WI
At SSM Health, we believe in providing our employees with a fulfilling career. We strive to create an environment where individuals can grow both personally and professionally. Our company values diversity, innovation, and collaboration, and we are committed to making a positive impact on the communities we serve.
Joining SSM Health means becoming part of a team that is dedicated to providing exceptional patient care and making a difference in people's lives. Our employees are passionate about what they do, and their commitment to our mission is what sets us apart.
Remote work: This position may be eligible for remote work in accordance with SSM policies. Note that remote work is not permissible in some states; Human Resources should be consulted for additional information and guidance.
*Candidates must reside in MO, IL, OK, or WI
Job Summary:
Serves as a subject matter expert responsible for leading complex regulatory analysis, payer policy interpretation, and compliance-driven revenue cycle initiatives. Monitors federal, state, and commercial payer regulations to ensure organizational compliance, mitigate audit risk, and prevent revenue loss. Operates as a strategic partner across departments, driving large-scale projects, providing advanced guidance to analysts and operational teams, and ensuring alignment between regulatory requirements and revenue cycle operations. Functions in a leadership capacity through influence, expertise, and project ownership.Job Responsibilities and Requirements:
- Analyzes and interprets complex regulatory changes from CMS, Medicare Administrative Contractors (MACs), Medicaid, and commercial payers.
- Translates regulatory guidance into actionable operational workflows and billing practices.
- Serves as an organizational subject matter expert on reimbursement and compliance requirements.
- Leads large-scale, cross-functional revenue cycle and compliance projects from initiation through implementation.
- Coordinates efforts across departments including coding, billing, clinical operations, compliance, and finance.
- Develops project plans, timelines, and deliverables to ensure timely execution of regulatory initiatives.
- Supports audit response efforts, including documentation review, appeal strategy, and corrective action planning.
- Provides advanced education and guidance to revenue cycle teams and operational leaders.
- Develops training materials and communications related to regulatory updates and compliance expectations.
- Acts as a liaison between regulatory guidance and frontline operational execution.
- Performs other duties as assigned.
EDUCATION
Bachelor's degree
EXPERIENCE
Five years' experience
PHYSICAL REQUIREMENTS
Frequent lifting/carrying and pushing/pulling objects weighing 0-25 lbs.
Frequent sitting, standing, walking, reaching and repetitive foot/leg and hand/arm movements.
Frequent use of vision and depth perception for distances near (20 inches or less) and far (20 feet or more) and to identify and distinguish colors.
Frequent use of hearing and speech to share information through oral communication. Ability to hear alarms, malfunctioning machinery, etc.
Frequent keyboard use/data entry.
Occasional bending, stooping, kneeling, squatting, twisting and gripping.
Occasional lifting/carrying and pushing/pulling objects weighing 25-50 lbs.
Rare climbing.
REQUIRED PROFESSIONAL LICENSE AND/OR CERTIFICATIONS
- None
Work Shift:
Day Shift (United States of America)Job Type:
Department:
Benefits:
SSM Health values our exceptional employees by offering a comprehensive benefits package to fit their needs.
Paid Parental Leave: we offer eligible team members one week of paid parental leave for newborns or newly adopted children (pro-rated based on FTE).
Flexible Payment Options: our voluntary benefit offered through DailyPay offers eligible hourly team members instant access to their earned, unpaid base pay (fees may apply) before payday.
Upfront Tuition Coverage: we provide upfront tuition coverage through FlexPath Funded for eligible team members.
SSM Health is an equal opportunity employer. SSM Health does not discriminate on the basis of race, color, religion, national origin, age, disability, sex, sexual orientation, gender identity, pregnancy, veteran status, or any other characteristic protected by applicable law. Click here to learn more.
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