119 applicants

Company

Parallon · 11 hours ago

Billing Integrity Analyst RN

Brentwood, TN

Full-time

Remote

Mid Level

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Responsibilities

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 Billing 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.

Practice and adhere to the 'Code of Conduct' philosophy and 'Mission and Value Statement'.

Other duties as assigned

Qualification

Find out how your skills align with this job's requirements. If anything seems off, you can easily click on the tags to select or unselect skills to reflect your actual expertise.

Registered Nurse LicenseCPT CodesHCPCS CodesCharge ReviewsHealthcare ExperienceClinical ExpertiseRegulatory CompliancePatient Accounting Systems

Required

RN or other advanced nursing degree required.

Knowledge of CPT/HCPCS codes or experience in charging or performing charge reviews.

Active Registered Nurse License or other advanced nursing license required. Compact license for all states accepted.

Preferred

Healthcare experience in an acute care hospital or coding experience preferred.

Benefits

Comprehensive medical coverage that covers many common services at no cost or for a low copay.

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.

Company

Parallon

Glassdoor

3.2

Headquartered in Nashville, Tenn., Parallon provides full-service revenue cycle management and, ultimately, total patient account resolution for HCA Healthcare.

Founded in 1991