Revenue Integrity Clinical Coding Analyst RN - HCA Healthcare

Description

Introduction

Do you want to join an organization that invests in you as a Revenue Integrity Clinical Coding 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.

Benefits

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 Coding Analyst RN like you to be a part of our team.

Job Summary and Qualifications

The Revenue Integrity Clinical Coding 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:

• During the implementation of Meditech Expanse, is responsible for conversion related charging activity including but not limited to the mapping between Facility chargemaster and Meditech Expanse, performance of concurrent charge reviews to support the application of charges in Patient Accounting, reconciliation of charging based on swings in gross charges, monitoring to ensure charges are in compliance with HCA and regulatory requirements.
• During the implementation of Meditech Expanse, is responsible for constant communication with Facility Departments to address any identified charging issues prior to and post go-live. It is the responsibility of this position to ensure the Facility CFO will be kept up to date on progress related to charging activity.
• Consistently monitors charging practices across all facilities to include charge reviews, remedial training and education.
• Provide education and training to Facility Departments on the Charge Reconciliation reporting. Performs oversight and trending of reporting on a monthly basis.
• Works directly with Facility Departments by providing education to support HCA charging practices and regulatory requirements.
• Work directly with Facility Department Directors when standing up new service lines and/or procedures to develop chargemaster and charging practices utilizing approved standardization guidelines. Monitors charging practices upon implementation to provide specific guidance related to charging activity and provide support with education.
• Serves 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. 
• Reviews Regulatory and Compliance Communications, applicable CMS transmittals, and Local Coverage Decisions (LCD). Assess impact to Revenue Integrity procedures and implement changes as needed.
• Works on Charge Optimization projects when time permits and supports the Corporate RI team when necessary on special projects, charge reviews and patient audits. 

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. 
• Experience Coder with Revenue Integrity background preferred.
• Medical Necessity and Clinical Analysts experience 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 Clinical 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.