DescriptionSHIFT: Work From Home
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.
• RN or other advanced nursing degree required
Healthcare experience in an acute care hospital with 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
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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.