Revenue Integrity Clinical Review Analyst RN

Do you have the career opportunities as a Revenue Integrity Clinical Review 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. 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). Job Summary and Qualifications The Revenue Integrity Clinical 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 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.

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 a 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.