DescriptionSHIFT: Work From Home
Revenue Integrity Analyst - Registered Nurse
Parallon - Houston
Schedule: Full-time (Work from Home)
Are you looking for an organization that places integrity over their bottom line? Here at HCA Healthcare, our everyday decisions are founded on compassion. Apply today and join a team that is dedicated to serving others in need.
We want to ensure your needs are met. We offer a variety of comprehensive medical, dental, and vision plans along with some unique benefits including:
We offer you an excellent total compensation package, including competitive salary, excellent benefit package and growth opportunities. Your benefits include 401k, PTO medical, dental, flex spending, life, disability, tuition reimbursement, employee discount program, employee stock purchase program and student loan repayment. We would love to talk to you about this fantastic opportunity.
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 dedicated professionals like you to be a part of our Enter Department Name team. Join us in our efforts to better our community!
As a Revenue Integrity RN, you are responsible for determining the appropriateness of patient charges, and Charge Description Master (CDM) assigned HCPCS/CPTs, by reviewing the medical record, facility protocol, and other applicable documentation. This review includes the verification of billing data for accuracy and completeness, following regulatory requirements, in order to resolve edits or exceptions detected during system processing of the claim in Patient Accounting, Relay Health or the payer. Applies modifiers when appropriate based on this review, and/or makes necessary adjustments to patient account charges and/or balances.
Analyze and resolve specific billing edits that require an RNs clinical expertise and that are delaying claims from processing in the Patient Accounting and/or Relay Health systems. This includes the verification (and/or correction) of billing data for accuracy and completeness, by following regulatory requirements, and reviewing the medical record, facility protocol, and other applicable documentation. This also includes the application of modifiers and condition codes, as appropriate.
Identify charging, coding, or clinical documentation issues and work with appropriate leadership and ancillary departments to resolve issues.
Perform charge audits reviews by verifying billing data as compared to documentation and making corrections in Patient Accounting as needed.
Analyze charge review findings, provide recommendations to facility ancillary department directors in order to improve documentation, charging flow, and accuracy.
Serve as chargemaster liaison to facilitate clinical department education on appropriate charging of CPT codes, Revenue Codes, and communicating with Ancillary Departments to resolve issues. Coordinates updates (activate, inactivate, modification) with Ancillary Departments as necessary
Performs assigned charge reviews (governmental, corporate, insurance defense, patient requested, collections, denials, focused review, SPAEs, cosmetics, etc.) by researching documentation, analyzing information, entering all corrections as needed and communicating error trends to provide process improvement opportunities.
Review Regulatory and Compliance Communications, applicable CMS transmittals, and Local Coverage Decisions (LCD). Assess impact to Revenue Integrity procedures and implement changes as needed. Perform NCD LCD Coverage review when requested.
Participate in customer service events at the facility such as facility FECC Committee, new director onboarding, charge education and report charging issues as appropriate.
Maintain billing education, attend webcasts and conference calls as required.
Healthcare experience in an acute care hospital or coding experience preferred. Knowledge of CPT/HCPCS codes or experience in charging or performing charge reviews
• Active Registered Nurse License or other advanced nursing license required
Parallon is an industry leader in revenue cycle services. We partner with over 650 hospitals and 2,400 physician practices nation-wide. Our parent company, HCA Healthcare has been consistently named a World’s Most Ethical Company by Ethisphere and is ranked in the Fortune 100. We are dedicated to ensuring our patients have the best experience even after they leave our facilities.
If you are looking for an opportunity that provides satisfaction and personal growth, we encourage you to apply. We promptly review all applications. Qualified candidates will be contacted for interviews. Unlock the possibilities and apply today!
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.
Our Company’s recruiters are here to help unlock the next possibility within your career and we take your candidate experience very seriously. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Gmail or Yahoo Mail. If you feel suspicious of a job posting or job-related email, let us know by clicking here.
For questions about your job application or this site please contact HCAhrAnswers at 1-844-422-5627 option 1.
For questions about your job application or this site, please contact:
HCAhrAnswers at 1-844-422-5627 option 1.