Rochester Regional Health

Role Description The Coding Integrity Coordinator is responsible for monitoring and performing audits on inpatient or outpatient coded data for accuracy based on documentation in the medical record. Through these audits, the Coordinator ensures medical records are coded and billed in accordance with coding conventions, billing rules, Federal & State regulations, and RGHS policies. The Coordinator recommends, provides, and coordinates training, education, and feedback to all coders regarding coding regulations and compliance; serves in an advisory and educator capacity to coding staff, medical staff, and other RGHS team members as it relates to documentation, coding, and regulatory compliance; provides mentoring for new coding staff and assists Coding leadership with improving coding services. Qualifications - Associates or Bachelor’s degree in HIM. - Five years of recent inpatient and/or outpatient coding experience in an acute care setting. - Extensive knowledge of coding principles and guidelines. - Extensive knowledge of reimbursement systems, as well as federal, state, and payer-specific regulations and policies pertaining to documentation, coding, and billing. - Knowledge of RAC process including targeted DRGs. - Experience as an educator/trainer strongly preferred. - Knowledge of EPIC preferred. - Analytical ability to gather and interpret data, evaluate reports, track processes, and determine methods for ensuring coding compliance. - Strong communication, organizational, and time management skills. - Results oriented with demonstrated skills in problem identification and resolution. - Must be self-motivated and require minimal supervision with the ability to establish own priorities. - Must have the ability to interact professionally with providers, management, and staff. - Proficient in Microsoft Office applications and others as required. - Applicant must successfully pass a practical coding examination. Requirements - Successful completion of AHIMA or AAPC approved Coding Certificate required. - Advance coding certification credential: CCS, CCS-P, CPC, CPC-H, CMC, preferred. - If RHIT or RHIA is held, certifications are not required. Benefits - Pay Range: $62,400.00 - $80,000.00 Physical Requirements S - Sedentary Work - Exerting up to 10 pounds of force occasionally. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met. For disease-specific care programs, refer to the program-specific requirements of the department for further specifications on experience and educational expectations, including continuing education requirements. Any physical requirements reported by a prospective employee and/or employee’s physician or delegate will be considered for accommodations. Company Description Rochester Regional Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, sex (including pregnancy, childbirth, and related medical conditions), sexual orientation, gender identity or expression, national origin, age, disability, predisposing genetic characteristics, marital or familial status, military or veteran status, citizenship or immigration status, or any other characteristic protected by federal, state, or local law.

Role Description The Denial Management Coordinator oversees the coordination and tracking of Rochester Regional Health responses to the Centers for Medicare and Medicaid Services (CMS) Recovery Audit Contractor (RAC), Medicare Administrative Contractor (MAC), Comprehensive Error Rate Testing Contractors (CERT) pre and post payment reviews as well as medical necessity and/or DRG denials for non-governmental commercial payers for both inpatient and outpatient encounters. Demonstrates knowledge of healthcare compliance, revenue cycle and audit recovery activities. The position requires strong communication skills, time management, and organizational skills as well as the ability to work collaboratively with clinicians, support, staff and senior leaders through the RRH system. Key Responsibilities - Coordinate response to all denial inquiries to ensure all submissions are within mandated timeframes. - Assist with written response and collection of all required information through the adjudication process to ensure it is complete, comprehensive and convincing. - Prioritize review of claims by evaluating due dates and impact by revenue and volume on health system. - Receive, log and track all denial activity and correspondence for government and commercial payers for both inpatient and outpatient. - Maintain accurate database of all denial activity to closure to help manage and track denial hand-offs between departments. - Develops and maintains clear communication channels with internal insurance reviewers and recovery audit contractors. - Utilizes aggregate denial activity data to provide HIM Leadership with information that will support the health system in identifying areas in need policy, procedure or process improvement related to documentation, coding errors and/or utilization management issues. - Works closely with Physician Advisor team to escalate issues and provide education to providers on emerging issues. - Partners with HIM Leadership and key health system personnel to limit risk of past and future payment errors identified by federal and state contractors as well as private insurers. - Identify common and overlapping issues. Alert health system leadership of targeted service lines. - Develops and prepares various reports for RRH Senior Leadership, key medical staff and clinical department leadership. - Works with the Denials Specialist and Physician Advisor leadership to develop and refine policies and procedures in order to ensure standard processes are in place across the system. - Develops and documents procedures and training materials for data collection within the denial tracking software. - Trains new staff on processes and software functionality. - Coordinate ad hoc meetings, as needed, on an immediate basis; if/when denial activity requires swift review and determination of health system response. - Provides RRH Leadership with updates on process changes or present and future denial regulations and/or modifications. - Maintains access to the database tracking mechanism to include adding new users and deactivating users as applicable. Qualifications - Experience with claim denials, audit management and appeal processing, preferred. - Current certification as an RHIA, RHIT, RN, CCS, or CCS-P, preferred. - Experience working with coding, revenue cycle, and utilization management, preferred. - Knowledge of medical necessity, coding and documentation guidelines for Medicare, Medicaid and other third party payers, preferred. - Experience with Epic EHR, preferred. - Experience in preparing and presenting educational material to staff and providers, preferred. Requirements - AAS or two or more years of relevant work experience within the healthcare revenue cycle, e.g. Patient Access, HIM, PFS, or other role related to denial management. Licensure/Certification - RHIT or RHIA; CCS preferred. - Earned coding credential of Certified Coding Specialist (CCS) preferred. Physical Requirements Sedentary Work - Exerting up to 10 pounds of force occasionally. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met. Pay Range $19.75 - $24.50 City Rochester Postal Code 14617

Role Description The Clinical Trials Scientific Affairs Pre Award Senior Analyst is responsible for the review of study protocols and investigating testing requirements to assist in facilitating the timely response for proposals. This position will act as a link and interface between the laboratory and other departments; i.e., sales, proposals, and project management. The CTSA Senior Analyst serves as a subject matter expert within the team, provides support with escalations, and assists with team member training. - Investigate testing requirements within a clinical trial protocol and help determine testing facilities to identify required testing and associated nuances for the timely and accurate response for proposals. - Review and prepare pricing documents, as needed, noting and correcting any discrepancies. - Maintain relationships between ACM and referral laboratories. - Provide scientific/technical information to compile client RFPs and RFIs. - Provide feedback to the manager to address analytical trends or issues, to support business needs. - Assist in coordinating the testing methods with referral labs, as needed. - Obtain and document referred testing information throughout the course of the active trial, including contracting with referral labs. - Assume responsibility for channeling information to and from Laboratory Operations and Sales. - Alert leadership to any issues during the life cycle of study related and testing needs. - Alert leadership to any issues with referral laboratories, assist with root cause analysis. - Suggest and help implement improved work methods and ways to increase efficiency, reduce costs, and solve operational problems. - Liaison with internal and external partners and participate in client teleconferences to address new business needs or ongoing study issues. - Understand and follow company policies and procedures and respect patient confidentiality. - Provide consultation to clinical trials operations and external clients, as needed. - Assist with training and guidance of new team members. - Work with leadership to update global SOPs, as needed. - Triage upcoming work and determine staffing capabilities and workload for assignments. - Serve as subject matter expert to internal and external clients. - Serve as escalation point for internal and external clients. - Assist in development, maintenance, and updates to templates and tools. - Perform other duties as assigned. Qualifications - Bachelor’s Degree or 3+ years as a clinical laboratory scientist. - 3 years relevant laboratory experience. - 2 years clinical trials experience. Requirements - Strong interpersonal and communication skills. - Strong time management and organizational skills. - Ability to manage multiple projects with tight deadlines. - Ability to work independently and in a team setting. - Proficient in Microsoft Office. - Generalist laboratory experience. - Ability to lead and positively motivate others. - MT (ASCP) Certification - Preferred. Benefits - Pay range: $90,000.00 - $100,000.00. - Eligible for additional pay components. - Pay determined by factors including experience, relevant qualifications, specialty, internal equity, location, and contracts. Company Description Rochester Regional Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, sex (including pregnancy, childbirth, and related medical conditions), sexual orientation, gender identity or expression, national origin, age, disability, predisposing genetic characteristics, marital or familial status, military or veteran status, citizenship or immigration status, or any other characteristic protected by federal, state, or local law.

Role Description summary statement here Qualifications - text - text Requirements - M - Medium Work - Exerting 20 to 50 pounds of force occasionally - 10 to 25 pounds of force frequently - Greater than negligible up to 10 pounds of force constantly to move objects - Requires frequent walking, standing or squatting Company Description Rochester Regional Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, sex (including pregnancy, childbirth, and related medical conditions), sexual orientation, gender identity or expression, national origin, age, disability, predisposing genetic characteristics, marital or familial status, military or veteran status, citizenship or immigration status, or any other characteristic protected by federal, state, or local law.

• Provides leadership and subject matter expertise to the coding team across inpatient and/or outpatient care settings. • Ensures daily operational functions are met, supports coding quality and compliance. • Serves as a super user and resource for internal and external stakeholders. • Monitors daily activity of coding work queues to support productivity benchmarks and turnaround times. • Collaborates with various stakeholders to identify and resolve coding-related issues impacting reimbursement or compliance. • Maintains regular hands-on coding responsibilities.

• Educates front end users on expected standards for key deliverables • Provides ongoing education and acts as a resource for front end users • Supports front end revenue cycle scorecard metrics • Develops an action plan for areas unable to follow best practices • Tracks and documents correlations in gaps of training and workflows • Collaborates with Corporate Compliance, Site Leadership and patient access leadership

Role Description As a Registered Nurse (RN), you’re the engine and the heart of patient care at Rochester Regional Health. You make a positive difference every single day in the lives of our patients, their family members and visitors – going above and beyond to meet their needs with courtesy, kindness, respect and compassion. Responsibilities - Provides high-quality, patient-centered, clinical care. - Performs initial and ongoing assessment of the patient, utilizing appropriate data (i.e. physical, psychological, educational and risk-screen data appropriate for the chronological/developmental age of the patient). - Communicates and documents assessment of patient with the interdisciplinary team. - Utilizes all available resources in order to meet the needs of the patient and family. - Develops and documents plan of care, treatment and services which is individualized and appropriate for the patient needs, strengths, limitations and goals. - Complies with organizational policies, procedures and protocols including policies governing safety, medication administration and documentation. - Revises plan of care based on ongoing evaluations and updates documentation appropriately. - Completes at least one clinical research utilization (CRU) form for submission to Nursing Research Department utilizing a research article from the last 5 years from research performed in the United States. - Completes a minimum of 5 nationally approved contact hours (CNE or CEU) per year. - Completes mandatory in-services and health screens in timely manner. - Maintains Basic Life Support (BLS) certification. Qualifications - Diploma or Associate’s Degree in Nursing. - Registered Nurse license in New York State. - Basic Life Support (BLS) certification. Preferred Qualifications - Bachelor’s Degree in Nursing preferred. Education - AS: Nursing (Required) Licenses / Certifications - BLS - Basic Life Support - American Heart Association (AHA) - RN - Registered Nurse - New York State Education Department (NYSED) Physical Requirements M - Medium Work - Exerting 20 to 50 pounds of force occasionally, and/or 10 to 25 pounds of force frequently, and/or greater than negligible up to 10 pounds of force constantly to move objects; Requires frequent walking, standing or squatting. For disease specific care programs refer to the program specific requirements of the department for further specifications on experience and educational expectations, including continuing education requirements. Any physical requirements reported by a prospective employee and/or employee’s physician or delegate will be considered for accommodations. Pay Range $35.34 - $47.13 City Rochester Postal Code 14617 The listed base pay range is a good faith representation of current potential base pay for a successful full time applicant. It may be modified in the future and eligible for additional pay components. Pay is determined by factors including experience, relevant qualifications, specialty, internal equity, location, and contracts. Rochester Regional Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, sex (including pregnancy, childbirth, and related medical conditions), sexual orientation, gender identity or expression, national origin, age, disability, predisposing genetic characteristics, marital or familial status, military or veteran status, citizenship or immigration status, or any other characteristic protected by federal, state, or local law.

• Review clinical documentation and diagnostic results to extract data and apply appropriate ICD-10-CM and ICD-10-PCS codes for billing, internal and external reporting, research, and regulatory compliance. • Demonstrate knowledge of reimbursement methodologies and apply these to assigned charts to optimize reimbursement and/or resolve regulatory edits. • Resolve error reports associated with billing process, identify and report error patterns, and, when necessary, assist in design and implementation of workflow changes to reduce billing errors. • Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA), adheres to official coding guidelines, and keeps abreast of coding changes and interpretation of codes. • Complies with RRH & HIM department policies & procedures • Perform detailed review of Inpatient record documentation to identify & assign diagnosis & procedure codes using ICD-10-CM and ICD-10-PCS. • Meets established departmental productivity guidelines with 95% accuracy on a consistent basis. • Utilizes Care Connect, UDS and Clintegrity systems proficiently to obtain ICD10 codes and DRG assignment. • Formulates compliant Physician Coding Queries when documentation is inadequate, ambiguous or unclear for coding purposes • Enters and/or updates data accurately including Present on Admission (POA) indicators, Point of Origin, Discharge Disposition and other identified data. • Manages problematic workflow edits and other technical issues to ensure timely resolution specific to coding A/R days • Corrects failed claim errors to billing edits, accounts misclassified and/or other errors identified through various auditing processes in a timely manner. • Attends RGHS, HIM Department and Coding Team meetings and training sessions as required. • Ensure timely reporting for external regulations • Completes other duties as assigned by HIM leadership. • Provide assistance to customers (physicians, clinical quality staff) regarding clinical documentation opportunities, coding reimbursement issues, and quality improvement review process.

Role Description The FERC Supervisor coordinates and provides direct supervision of the day-to-day operations of a front-end revenue cycle team in one or more outpatient sites. The responsibilities will also include scheduling, coaching, training, and mentoring to assure proper data flow and resource utilization. Tracks ongoing team performance as it relates to claim work queues, productivity, and data integrity. Ensures staff members maintain a thorough knowledge of billing procedures and registration collection. Participates with other peers and higher management in department planning and budgetary processes. The FERC supervisor also has the ability to implement changes in procedures at their discretion. The FERC office supervisor will work collaboratively with RGMG administration and site practice managers to ensure that Access Associates support the efficient and effective operation of the office. In addition to revenue cycle activities, Access Associates serve important hospitality and safety functions. They must exhibit excellent customer service to help ensure high patient satisfaction. Though not clinically trained, Access Associates must also diligently monitor the waiting areas and have a high degree of sensitivity to any expression of distress by those at our doors or within our centers, and respond assertively in communicating with clinical personnel to quickly evaluate anyone expressing (verbally or non-verbally) such distress. Qualifications - Associate’s Degree or equivalent preferred. - 5 years previous experience in office operations, preferably in billing and data management. - Experience as a Senior or Lead Access Associate desirable. - Proficient with PC and office programs including database management, spreadsheets, and presentation software. - Excellent customer service and communication skills required. - Must demonstrate excellent written, verbal communication, organization, and people skills with demonstrated ability to lead or direct people. - Basic computer skills required – experience with IDX BAR and/or Epic Cadence or similar applications preferred. Requirements - Directs, coordinates, and supervises the front-end operations of an ambulatory setting. - Trains and mentors front-end staff on work processes and customer service. - Keeps manager apprised of team members’ performance, employee issues, and any unusual situations or events that may occur. - Schedules and maintains adequate staffing coverage to ensure operational demands are met. - Participates with manager in reviewing performance indicators including but not limited to claim edit work queues, POS copays and payments, charge entry completion. - Ensures compliance with all departmental, organizational, and regulatory standards and policies by cascading to front office staff. - Works with front office team members in identifying services where no payment source has been confirmed; follow up with communication to financial assistance and/or payment arrangements. - Verification of insurance eligibility/coverage and obtaining necessary pre-certifications/authorizations when applicable. - Ensures the accuracy of all data collected including registration and encounter charge entry before claims are submitted. - Communication with external customers such as but not limited to payers, physician offices, and other departments. - Contributes effectively to the budget process by helping to identify potential variances. - Recommends Human Resource actions and pay decisions for direct reports. Benefits - Pay range: $62,400.00 - $70,000.00 - Pay is determined by factors including experience, relevant qualifications, specialty, internal equity, location, and contracts. Company Description Rochester Regional Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, sex (including pregnancy, childbirth, and related medical conditions), sexual orientation, gender identity or expression, national origin, age, disability, predisposing genetic characteristics, marital or familial status, military or veteran status, citizenship or immigration status, or any other characteristic protected by federal, state, or local law.

Role Description Architect, design, and evaluate hardware and software server solutions to specifications meeting customer and departmental needs. Responsible for complex system implementations and configurations on supported server hardware and software platforms. Maintains expert knowledge and sets standards for server configurations – both software and hardware. Occasionally acts as project leader for various Technical Services and Information Services and Technology projects. Key Responsibilities - Provides complex server engineering support for Information Services & Technology customers. - Provides server technical expertise on infrastructure projects or projects requested by the customer community. - Architects and designs fail safe storage solutions to accommodate our server systems, as observed by Manager. - Strategic Planning and Development. - System Maintenance and Performance. - Maintains a high degree of server engineering knowledge and overall computer expertise. - Performs other duties as assigned. Lead Responsibilities - Completes operations by assigning and monitoring work, gathering resources, implementing productivity standards, resolving operations problems, maintaining reference manuals, and implementing new procedures. - Maintains staff by orienting and training employees and developing personal growth opportunities. - Contributes to team effort by accomplishing related results as needed. - Analyze project needs/requirements and recommend systems to enable enterprise integration of systems and hardware. - Develop, maintain and communicate project plans and status updates to the PMO and other stakeholders to establish project timeline and report on progress. - Provides technical support for hardware and systems within the RRH infrastructure. - Provide input into the annual capital and expense budgeting process related to desktop & system engineering infrastructure. Qualifications - Bachelor's degree in computer science preferred. - Strong analytical, computer, and communication skills. Requirements - 5-10 years of experience with computer servers (i.e. Windows Server and cloud service providers like Azure or AWS). Benefits - Pay Range: $80,000.00 - $110,000.00