HCA Healthcare
Overview
Introduction
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 want to join an organization that invests in you as a Billing Integrity Analyst Credentialed? 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. Description
We are looking for a dedicated Billing Integrity Analyst Credentialed to determine the appropriateness of patient charges and CDM HCPCS/CPTs by reviewing the medical record, facility protocol, and other applicable documentation. This includes verifying billing data for accuracy and completeness, following regulatory requirements, and resolving edits or exceptions detected during system processing of claims. The role may require applying modifiers and making necessary adjustments to patient account charges and balances. The analyst analyzes accounts for specialized billing requirements and serves as a liaison between facilities Administration, Shared Services Center, and ancillary department directors regarding charging issues, clinical documentation issues, and revenue opportunities. What you will do in this role
Analyze and resolve specific billing edits that require HCPCS/CPT coding based on chargemaster expertise and that delay claims from processing in the Patient Accounting and/or Relay Health systems. This includes verifying (and/or correcting) billing data for accuracy and completeness, 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, chargemaster coding, or clinical documentation issues and work with appropriate leadership and ancillary departments to resolve issues identified while working on edits. Serve as charge master liaison to facilitate clinical department education on appropriate charging of CPT codes and Revenue Codes, and communicate with Ancillary Departments to resolve issues. Coordinate updates (activate, inactivate, modification) with Ancillary Departments as necessary. Review Regulatory and Compliance Communications, applicable CMS transmittals, and Local Coverage Decisions (LCD). Assess impact to Billing Integrity procedures and implement changes as needed. Maintain billing education, attend webcasts and conference calls as required. What qualifications you will need
Associate degree or above; or healthcare license/certification required. Minimum 1 year directly related Healthcare experience or coding experience required. Knowledge of CPT/HCPCS codes or experience in charging or performing charging validation reviews preferred. Healthcare certification/licensure such as RHIT, CCS, CCP, CPC or other recognized AHIMA certified coding credential, LPN, LVN, RT, PT, etc., can be accepted in lieu of degree with work experience. Parallon
provides full-service revenue cycle management for HCA Healthcare. Our services include scheduling, registration, insurance verification, hospital billing, revenue integrity, and related functions. Parallon has over 17,000 colleagues and serves many hospitals and physician practices. HCA Healthcare has been recognized as one of the World's Most Ethical Companies by the Ethisphere Institute. We are a family of 270,000 dedicated professionals. Our Talent Acquisition team is reviewing applications for our Billing Integrity Analyst Credentialed opening. Qualified candidates will be contacted for interviews. Submit your resume today to join our community of caring! 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. Seniority level
Entry level Employment type
Full-time Job function
Health Care Provider Industries
Hospitals and Health Care
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Introduction
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 want to join an organization that invests in you as a Billing Integrity Analyst Credentialed? 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. Description
We are looking for a dedicated Billing Integrity Analyst Credentialed to determine the appropriateness of patient charges and CDM HCPCS/CPTs by reviewing the medical record, facility protocol, and other applicable documentation. This includes verifying billing data for accuracy and completeness, following regulatory requirements, and resolving edits or exceptions detected during system processing of claims. The role may require applying modifiers and making necessary adjustments to patient account charges and balances. The analyst analyzes accounts for specialized billing requirements and serves as a liaison between facilities Administration, Shared Services Center, and ancillary department directors regarding charging issues, clinical documentation issues, and revenue opportunities. What you will do in this role
Analyze and resolve specific billing edits that require HCPCS/CPT coding based on chargemaster expertise and that delay claims from processing in the Patient Accounting and/or Relay Health systems. This includes verifying (and/or correcting) billing data for accuracy and completeness, 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, chargemaster coding, or clinical documentation issues and work with appropriate leadership and ancillary departments to resolve issues identified while working on edits. Serve as charge master liaison to facilitate clinical department education on appropriate charging of CPT codes and Revenue Codes, and communicate with Ancillary Departments to resolve issues. Coordinate updates (activate, inactivate, modification) with Ancillary Departments as necessary. Review Regulatory and Compliance Communications, applicable CMS transmittals, and Local Coverage Decisions (LCD). Assess impact to Billing Integrity procedures and implement changes as needed. Maintain billing education, attend webcasts and conference calls as required. What qualifications you will need
Associate degree or above; or healthcare license/certification required. Minimum 1 year directly related Healthcare experience or coding experience required. Knowledge of CPT/HCPCS codes or experience in charging or performing charging validation reviews preferred. Healthcare certification/licensure such as RHIT, CCS, CCP, CPC or other recognized AHIMA certified coding credential, LPN, LVN, RT, PT, etc., can be accepted in lieu of degree with work experience. Parallon
provides full-service revenue cycle management for HCA Healthcare. Our services include scheduling, registration, insurance verification, hospital billing, revenue integrity, and related functions. Parallon has over 17,000 colleagues and serves many hospitals and physician practices. HCA Healthcare has been recognized as one of the World's Most Ethical Companies by the Ethisphere Institute. We are a family of 270,000 dedicated professionals. Our Talent Acquisition team is reviewing applications for our Billing Integrity Analyst Credentialed opening. Qualified candidates will be contacted for interviews. Submit your resume today to join our community of caring! 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. Seniority level
Entry level Employment type
Full-time Job function
Health Care Provider Industries
Hospitals and Health Care
#J-18808-Ljbffr