Revenue Integrity RN Clinical Analyst

HCA Healthcare; Brentwood (TN); On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

Medical, dental, vision benefits

401(k) with match

Job summary

HCA Healthcare is seeking a Revenue Integrity Clinical Analyst in Brentwood, TN to ensure accurate patient registrations, charge capture, and entry for medical transportation services. You will act as a clinical SME for the revenue integrity team and work with HIM to ensure compliant documentation.

Qualifications include RN licensure in the practice state, an associate degree, and CAC certification within 6 months.

Qualifications

• Associate’s degree required.
• Bachelor’s degree preferred.
• 1+ year of experience in medical billing preferred.
• Registered Nurse licensed in the practicing state is required.
• CAC certification to be completed within 6 months of hire.

Responsibilities

• Ensure charts/accounts are timely and accurately completed.
• Obtain accurate patient data for registration and billing with facilities.
• Enter transport charges into the system accurately.
• Reconcile charges weekly or daily as requested by Finance.
• Maintain spreadsheets of transports, charges, and regulatory documents.
• Obtain necessary signatures for treatment/transport from crew.
• Prepare transport records for HPF and On-Base; coordinate with HIM as needed.
• Perform clinical review of critical care accounts for appropriate care level.
• Support revenue integrity analyst team as SME.
• Develop QA program for front-end revenue cycle processes under Director guidance.
• Conduct recurring QA/quality audits for accuracy and compliance.
• Collaborate with hospital, Parallon, and stakeholders on charging and billing issues.
• Identify process improvements to drive efficiencies.
• Provide exemplary customer service to internal/external customers.

Education

Associate’s degree

Bachelor’s degree preferred

Tools

Horizon Patient Folder (HPF)

Expanse management

Health Information Management (HIM) systems

Job description

Experience the HCA Healthcare difference where colleagues are trusted, valued members of our healthcare team. Grow your career with an organization committed to delivering respectful, compassionate care, and where the unique and intrinsic worth of each individual is recognized.

Job Summary And Qualifications

The Revenue Integrity Clinical Analyst is responsible for timely and accurate patient registrations, charge capture, and charge entry on behalf of HCA Medical Transportation programs for billable transports, with a focus on critical care transports. Serves as clinical SME for revenue integrity team. Additionally, efficiently and accurately reviews and compiles documents for medical records. Role requires extreme attention to detail regarding compliance regulations of HCA Patient Account Services, Horizon Patient Folder/Expanse management, and HCA Healthcare’s Ethics and Compliance.

What you will do in this role

• Ensures charts/accounts are timely and accurately completed.
• Works with facilities to obtain accurate, updated patient data for registration and billing.
• Timely and accurately completes patient registrations.
• Enters appropriate transport charges into the system.
• Reconcile charges at the end of the week or daily as requested by Finance.
• Maintains spreadsheets of all transports, transport charges, and documentation for regulatory requirements and related billing.
• Ensures that all necessary signatures are obtained for treatment/transport from crew.
• Prepares, compiles, and organizes each transport clinical record, clinical attachments, and dispatch record for Horizon Patient Folder (HPF) and On-Base; works closely with Health Information Management (HIM) teams as needed to ensure correct documentation is obtained
• Responsible for clinical review and processing of critical care patient accounts to sure appropriate level of care is determined and documentation.
• Serves as a clinical subject matter expert (SME) for revenue integrity analyst team.
• Under the direction of the Director, Business Development – Medical Transportation Services, develop standardized quality assurance program for front end revenue cycle processes, including registration, charge capture, and charge entry.
• Performs recurring quality assurance and quality audits of patient accounts & documentation to ensure accuracy and compliance.
• Collaborates with hospital, Parallon, and other key stakeholders on charging, documentation, and billing issues.
• Identifies opportunities for process improvements to drive efficiencies.
• Provide exemplary and timely Customer Service to internal and external customers.
• Maintains access to all applications to ensure accurate processing of accounts.
• Able to perform correspondence in the course of performing account follow up and elevate any identified issues to the appropriate area.
• Understand/explain services related to pricing, insurance billing, and payment of account through the revenue cycle management of an account.
• Attends in-service presentations and completes mandatory classes and education standards, including continuing education requirements for required job certifications
• Other duties as assigned.
• Practices and adheres to the “Code of Conduct” philosophy and “Mission and Value Statement.”

Qualifications

• Associate’s degree required
• Bachelor’s degree preferred
• 1+ year(s) of experience in medical billing preferred
• Registered Nurse - Currently licensed as a registered professional nurse in the state in which he or she practices, in accordance with law and regulation required
• Certified Ambulance Coder (CAC) - To be completed within 6 months of hire date (if not certified at the time of hire); continuing education to maintain license required

Benefits

Parallon offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:

• Comprehensive benefits for medical, prescription drug, dental, vision, behavioral health and telemedicine services
• Wellbeing support, including free counseling and referral services
• Time away from work programs for paid time off, paid family leave, long- and short-term disability coverage and leaves of absence
• Savings and retirement resources, including a 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service), Employee Stock Purchase Plan, flexible spending accounts, preferred banking partnerships, retirement readiness tools, rollover support and financial wellbeing counseling
• Education support through tuition assistance, student loan assistance, certification support, dependent scholarships and a partnership with Galen College of Nursing
• Additional benefits for fertility and family building, adoption assistance, life insurance, supplemental health protection plans, auto and home insurance, legal counseling, identity theft protection and consumer discounts

Learn More About Employee Benefits

Note: Eligibility for benefits may vary by location.

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.

\"There is so much good to do in the world and so many different ways to do it.\"- Dr. Thomas Frist, Sr.

HCA Healthcare Co-Founder

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.