RI Analyst RN (Work From Home) - Parallon

This job is no longer active. View similar jobs.

POST DATE 9/13/2016
END DATE 10/22/2016

HCA Healthcare Norcross, GA

Company
HCA Healthcare
Job Classification
Full Time
Company Ref #
26013-123755
AJE Ref #
576162451
Location
Norcross, GA
Experience
Entry Level (0 - 2 years)
Job Type
Regular

JOB DESCRIPTION

APPLY
Job Code: 26013-123755

Full-time

Work From Home

Candidate must be live within 30 minutes of Eastside Hospital located in Snellville, GA.



Revenue Integrity Analyst RN -



GENERAL SUMMARY OF DUTIES Assist in resolving billing edits that are holding patient claims from billing, by reviewing medical records and other applicable documentation. Maintain the integrity of facility Charge Description Master (CDM) and Revenue Integrity Systems Program. Maintain the integrity of all Ancillary Department systems related to billing and revenue. Position will serve as liaison between Administration, the PAS and Ancillary Department Directors regarding revenue and compliance issues.

Position will coordinate all retrospective, concurrent, patient complaint and external billing audits. Provide monthly audit results. Develop and coordinate educational in-services to the Business Office staff and Ancillary staff related to charging and billing issues. Review denial trends for documentation or charging issue opportunities. Review high charge stays/procedures for charging accuracy. Ensures web tool (unbilled) items are addressed properly and timely. Serve as primary contact for all charge-related PAS

inquiries and issues.





Candidate must be live within 30 minutes of Eastside Hospital located in Snellville, GA.



DUTIES INCLUDE BUT ARE NOT LIMITED TO

* Analyzing and resolving patient claims being held by billing edits on the Bill 45, Bill 49, DET,CRTMedical necessity, Correct Coding Initiative, Outpatient Code Editor(OCE), Inpatient Code Editor, Self Administered and other claims requiring clinical expertise s

* Interact with ancillary departments to obtain additional information needed to properly bill account based on medical record

* Identify charging, coding, or clinical documentation issues and work with ancillary departments to resolve issues and notify appropriate leadership

* Reviews all BHL, Mutual, FCSO, PAS Billing Compliance correspondence and adheres to all guidelines

* Performs assigned audits by researching documentation, analyzing information, and makes recommendations to improve flow of claim and enters all corrections into the systems

* Serves as charge master liaison to include regular reviews of CPT codes, Revenue Codes, review of monthly standard CDM error report and communicating with Ancillary Departments to resolve issues

* Member of facility FECC Committee; reports charging issues, etc.

* Maintain mandated billing education (i.e. EM Assigner ), attend webcasts and conference calls per HCA Requirements

* Perform other related functions as assigned

KNOWLEDGE, SKILLS & ABILITIES

* Excellent communication skills both verbal and written

* Good interpersonal skills

* Able to establish good customer relationships with trust and respect

* Able to travel as needed

* Computer skills: navigation and edit resolution through various Web based systems, Ability to use email, Excel, Word

Last Edited: 08/23/2016