Remote Revenue Integrity Analyst RN (Parallon) 205 views

Job Overview

  • Specialty License RN
  • State License (Select 'ANY' & Your State) Any

SHIFT: Work From Home

SCHEDULE: Full-time

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:

    • 100% matching 401k based on years of service
    • Tuition Assistance/Reimbursement Programs
    • Consumer discounts on hundreds of goods and services
    • Leadership development programs
    • Auto, Home, and Life insurance options
    • Employee Stock Purchase Program (ESPP)
    • Medical and childcare flex spending accounts

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 Revenue Integrity 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.

What you will do in this role:
  • Analyze and resolve specific billing edits that require a RN’s 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
  • 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 or 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

 

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Remote Medical Jobs is a space designed to help medical professionals find work-from-home jobs. I am a nurse who works from home and, like a lunatic, I spend all my free time helping others do the same. Happy hunting!