Revenue Integrity teams are a committed group of colleagues who have a passion to create positive patient experiences.
We're seeking a self-motivated individual to work as a Revenue Integrity Analyst (Credentialed) to Work From Home.
As a Revenue Integrity Analyst (Credentialed), you will be responsible for (but not limited to):
Qualifications: KNOWLEDGE, SKILLS & ABILITIES •
- Determine the appropriateness of patient charges, and Charge Description Master (CDM) assigned HCPCS/CPTs, by reviewing the medical record, facility protocol, and other applicable documentation.
- 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.
- Apply modifiers when appropriate based on this review, and/or makes necessary adjustments to patient account charges and/or balances.
- Analyze accounts for specialized billing requirements that require a review of the medical record documentation, regulatory information, and HCA standards. Combines or splits accounts as appropriate.
- Serve as a liaison between facilities Administration, Shared Services Center, and ancillary department directors regarding charging issues, clinical documentation issues and revenue opportunities.
- Provides charge review results and develops and coordinates educational in-services for facility staff related to charging/billing issues.
- Coordinates retrospective, concurrent, patient requested, and external billing audits.
- Reviews denial trends for documentation and charging opportunities.
- Serves as a primary contact for charge related SSC and facility inquiries and issues.
Communication - communicates clearly and concisely, verbally and in writing.
• Customer orientation - establishes and maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations
• Interpersonal skills - able to work effectively with other employees, patients and external parties
• PC skills - demonstrates proficiency in Microsoft Office applications and others as required
• Policies & Procedures - demonstrates knowledge and understanding of organizational policies, procedures and systems
• Basic skills - demonstrates ability to organize, perform and track multiple tasks accurately in short timeframes, have ability to work quickly and accurately in a fast-paced environment while managing multiple demands. Ability to work both independently and collaboratively as a team player. Adaptability, analytical and problem solving ability. Attention to detail. Ability to perform basic mathematical calculations, balance and reconcile figures, punctuate properly, spell correctly and transcribe accurately. EDUCATION
• High school diploma or GED required.
• RHIT, CCS, CCP,CPC or other recognized AHIMA certified coding credential; other healthcare related credential such as (but not limited to) LPN, LVN or RT EXPERIENCE
Healthcare experience in an acute care hospital or coding experience preferred. Knowledge of CPT/HCPCS codes or experience in charging or performing charging validation reviews. CERTIFICATE/LICENSE
Active certification or licensure as a RHIT, CCS, CCP,CPC or other recognized AHIMA certified coding credential; other healthcare related credential such as (but not limited to) LPN, LVN or RT
A little about us:
HCA is the nation’s leading private provider of healthcare services. Comprised of locally managed facilities which include 230,000 employees at over 160 hospitals, over 120 surgery centers and 100 urgent care facilities in 20 states and the United Kingdom