Revenue Integrity Analyst RN in Nashville, Tennessee, United States
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Parallon

Revenue Integrity Analyst RN

Nashville, TN, United States
Full-time • Work From Home
Case Management   Job ID: 26012-191767
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Description

SHIFT: Work From Home
SCHEDULE: Full-time


Are you looking for a work environment where diversity and inclusion thrive? Submit your application with HCA Healthcare today and find out what it truly means to be a part of a team.


We are committed to providing our colleagues with the support they need. We offer an array of medical, dental, and vision packages as well as several add-on perks to make your benefits package truly customizable to you. Some of our unique benefits we offer include:


• Student Loan Repayment Program

• Tuition Reimbursement/Assistance Programs
• Moving, mortgage, and real estate assistance
• 100% matching 401k based on years of service
• Identity Theft Protection discounts
• Auto, Home, and Life Insurance options
• Adoption Assistance
• Employee Stock Purchase Program (ESPP)

 

We value your contributions. Our employee recognition programs encourage our teams to raise the bar. Come be a part of the change! 

 

The Revenue Integrity Analyst Register Nurse (RN) WORK FROM HOME determines the appropriateness of patient charges and Charge Description Master (CDM) assigned HCPCS/CPTs by reviewing the medical record, facility protocol, and other applicable documentation.  The RI Analyst RN applies modifiers when appropriate based on this review and/or makes necessary adjustments to patient account charges and/or balances and analyzes accounts for specialized billing requirements that require a review of the medical record documentation, regulatory information, and HCA standards. You will review denial trends for documentation and charging opportunities.  

 

In this role you will:

• Analyze and resolve specific billing edits that require an RN's clinical expertise and 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 audit 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

• Perform 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. 

 

Qualifications

EDUCATION

RN or other advanced nursing degree required

 

EXPERIENCE

Healthcare experience in an acute care hospital with coding experience preferred. Knowledge of CPT/HCPCS codes or experience in charging or performing charge reviews

 

CERTIFICATE/LICENSE – 

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.


HCA Healthcare is dedicated to the growth and development of our colleagues. We will provide you the tools and resources you need to succeed in our organization. We are actively reviewing applications. Highly qualified candidates will be promptly contacted for interviews. Submit your application and help us raise the bar in patient care!

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.
 
#ParallonBCOM 
 
 

Notice

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.

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Details

Case Management
Parallon
Full-time • Work From Home

About HCA Healthcare

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For questions about your job application or this site, please contact:
HCAhrAnswers at 1-844-422-5627 option 1.

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