at HCA in Overland Park, Kansas, United States
Description SHIFT: 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.
What you will do in this role:
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.
* RN or other advanced nursing degree 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... For full info follow application link.
We are committed to: Providing an inclusive work environment where everyone is treated with fairness, dignity and respect. Recruiting and retaining a diverse staff reflective of the patients and communities we serve. Equal employment opportunities are provided to all employees and applicants for employment without regard to race, color, religion, gender, national origin, citizenship, age, disability, sexual orientation, genetic information, gender identity, protected veteran status, or any other legally protected category in accordance to applicable federal, state, or local laws.
Overland Park, Kansas 66062