Revenue Integrity Clin Charge Review Analyst

Salary: $25.99 - $38.98 an hour
Full-time Work From Home

Description

Introduction

Do you want to join an organization that invests in you as a Revenue Integrity Clinical Charge Review Analyst RN? At Parallon, you come first. HCA Healthcare has committed up to $300 million in programs to support our incredible team members over the course of three years.

Parallon, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:

• Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.
• Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.
• Free counseling services and resources for emotional, physical and financial wellbeing
  
• 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)
  
• Employee Stock Purchase Plan with 10% off HCA Healthcare stock
  
• Family support through fertility and family building benefits with Progyny and adoption assistance.
  
• Referral services for child, elder and pet care, home and auto repair, event planning and more
  
• Consumer discounts through Abenity and Consumer Discounts
  
• Retirement readiness, rollover assistance services and preferred banking partnerships
  
• Education assistance (tuition, student loan, certification support, dependent scholarships)
  
• Colleague recognition program
  
• Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)
  
• Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.

Learn more about Employee Benefits

Note: Eligibility for benefits may vary by location.

You contribute to our success. Every role has an impact on our patients’ lives and you have the opportunity to make a difference. We are looking for a dedicated Revenue Integrity Clinical Charge Review Analyst RN like you to be a part of our team.

The Revenue Integrity Clinical Charge Review Analyst RN is responsible for determining the appropriateness of patient charges by reviewing the medical record, facility protocol, corporate standards and other applicable documentation. Provides charge review results and develops and coordinates educational in-services for facility staff related to charging/billing issues. Reviews denial trends for documentation and charging opportunities. Serves as a liaison between facilities Administration, Shared Services Center, and ancillary department directors regarding charging issues, clinical documentation issues and revenue opportunities.

In this role you will:

• Conduct reviews of charging, coding, and clinical documentation, collaborating with Corporate Revenue Integrity Leadership during Meditech Expanse implementation.
• Maintains constant communication with Facility Departments during Meditech Expanse implementation to address identified charging issues, both prior to and after go-live. This role ensures the Facility CFO is regularly updated on the progress of charging activities.
• Perform detailed charge audits by verifying billing data against clinical documentation, making necessary corrections in Patient Accounting. Based on audit findings, present recommendations to Corporate and SSC Revenue Integrity Leadership, as well as facility ancillary department directors, to enhance documentation accuracy, charging workflows, and overall compliance.
• Collaborates with Facility Department Directors in developing chargemaster and charging practices for new service lines or procedures, following approved standardization guidelines. Monitors charging practices post-implementation to offer targeted guidance and support.
• Consistently monitors charging practices across all facilities through charge reviews, remedial training, and education.
• Acts as Chargemaster liaison for clinical departments to facilitate education on appropriate charging of CPT codes and Revenue Codes. Collaborates with Ancillary Departments to resolve issues and coordinate necessary updates (activation, deactivation, or modification).
• Review HCA regulatory communications, applicable CMS transmittals, and Local Coverage Determinations (LCDs), assess their impact on Revenue Integrity procedures, and implement necessary changes.
• Maintain up-to-date billing knowledge through webcasts and conference calls, ensuring continuous education.
• Possess working knowledge of Medicare guidance, inpatient/outpatient status, and observation requirements.
• Knowledge of Revenue Cycle Pro, 3M Coding systems, and 3M Coding Resources.
• Participates in charge optimization projects and supports the Corporate Revenue Integrity team on special projects, charge reviews, and patient audits as needed.

Qualifications that you will need:

• Registered Nurse Degree required.
• Minimum 1 year directly related Healthcare experience required.
• Knowledge of CPT/HCPCS codes or experience in charging or performing charging validation reviews preferred.

Parallon provides full-service revenue cycle management, or total patient account resolution, for HCA Healthcare. Our services include scheduling, registration, insurance verification, hospital billing, revenue integrity, collections, payment compliance, credentialing, health information management, customer service, payroll, and physician billing. We also provide full-service revenue cycle management as well as targeted solutions, such as Medicaid Eligibility, for external clients across the country. Parallon has over 17,000 colleagues, and serves close to 1,000 hospitals and 3,000 physician practices, all making an impact on patients, providers, and their communities.

HCA Healthcare has been recognized as one of the World's Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.

"Good people beget good people."- Dr. Thomas Frist, Sr.

HCA Healthcare Co-Founder

We are a family 270,000 dedicated professionals! Our Talent Acquisition team is reviewing applications for our Revenue Integrity Charge Analyst opening. Qualified candidates will be contacted for interviews. Submit your resume today to join our community of caring!

We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.