Revenue Integrity Clinical Charge Analyst RN

Hourly Wage Estimate: $25.99 - $38.98 / hour
Learn more about the benefits offered for this job.

The estimate displayed represents the typical wage range of candidates hired. Factors that may be used to determine your actual salary may include your specific skills, how many years of experience you have and comparison to other employees already in this role. The typical candidate is hired below midpoint of the range.

This Work from Home position requires that you live and will perform the duties of the position; within 60 miles of an HCA Healthcare Hospital (Our hospitals are located in the following states: FL, GA, ID, KS, KY, MO, NV, NH, NC, SC, TN, TX, UT, VA).

Do you have the career opportunities as a Revenue Integrity Clinical Charge Analyst RN you want with your current employer? We have an exciting opportunity for you to join Parallon which is part of the nation's leading provider of healthcare services, HCA Healthcare.

Job Summary and Qualifications

The Revenue Integrity Clinical Charge 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. 
• Active Registered Nurse License or other advanced nursing license required

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 benefits for medical, prescription drug, dental, vision, behavioral health and telemedicine services
• Wellbeing support, including free counseling and referral services
• Time away from work programs for paid time off, paid family leave, long- and short-term disability coverage and leaves of absence
• Savings and retirement resources, including a 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service), Employee Stock Purchase Plan, flexible spending accounts, preferred banking partnerships, retirement readiness tools, rollover support and financial wellbeing counseling
• Education support through tuition assistance, student loan assistance, certification support, dependent scholarships and a partnership with Galen College of Nursing
• Additional benefits for fertility and family building, adoption assistance, life insurance, supplemental health protection plans, auto and home insurance, legal counseling, identity theft protection and consumer discounts

Learn more about Employee Benefits

Note: Eligibility for benefits may vary by location.

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.

"Bricks and mortar do not make a hospital. People do."- Dr. Thomas Frist, Sr.
HCA Healthcare Co-Founder

If you are looking for an opportunity that provides satisfaction and personal growth, we encourage you to apply for our Revenue Integrity Clinical Charge Analyst opening. We promptly review all applications. Highly qualified candidates will be contacted for interviews. Unlock the possibilities and apply today!

We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.