Revenue Integrity Clin Charge Review Analyst RN

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.

This position will require up to 60% travel. Introduction: Are you passionate about the patient experience? At HCA Healthcare, we are committed to caring for patients with purpose and integrity. We care like family! Jump-start your career as a Revenue Integrity Clinical Charge Review Analyst RN today with Parallon.

The Revenue Integrity Clinical Charge Review 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: Meditech Expanse Implementation: Responsible for managing conversion-related charging activities, including but not limited to mapping the Facility's chargemaster to Meditech Expanse, conducting concurrent charge reviews to support the application of charges in Patient Accounting, reconciling charges based on fluctuations in gross charges, and ensuring compliance with HCA and regulatory standards. Communication & Issue Resolution: Maintains constant communication with Facility Departments during Meditech Expanse implementation to address identified charging issues, both prior to and after go-live. This role ensures the Facility CFO is regularly updated on the progress of charging activities. Ongoing Charge Monitoring: Consistently monitors charging practices across all facilities through charge reviews, remedial training, and education. Training & Reporting Oversight: Provides education and training to Facility Departments on Charge Reconciliation reporting, overseeing and analyzing monthly reporting trends. HCA & Regulatory Compliance: Works directly with Facility Departments to provide education on HCA charging practices and regulatory requirements. Service Line Development: Collaborates with Facility Department Directors in developing chargemaster and charging practices for new service lines or procedures, following approved standardization guidelines. Monitors charging practices post-implementation to offer targeted guidance and support. Chargemaster Liaison: Acts as the liaison for clinical departments to facilitate education on appropriate charging of CPT codes and Revenue Codes. Collaborates with Ancillary Departments to resolve issues and coordinate necessary updates (activation, deactivation, or modification). Regulatory Compliance: Reviews regulatory and compliance communications, including applicable CMS transmittals and Local Coverage Determination (LCDs). Assesses their impact on Revenue Integrity procedures and implements necessary changes. Special Projects & Charge Optimization: Participates in charge optimization projects and supports the Corporate Revenue Integrity team on special projects, charge reviews, and patient audits as needed.