Revenue Integrity Team Lead Clinical in Richmond at Parallon

Date Posted: 7/9/2019

Job Snapshot

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Job Description

Revenue Integrity Team Lead Clinical – Work From Home – Full Time
Parallon believes that organizations that continuously learn and improve will thrive. That’s why after more than a decade we remain dedicated to helping hospitals and hospital systems operate knowledgeably, intelligently, effectively and efficiently in the rapidly evolving healthcare marketplace, today and in the future. As one of the healthcare industry’s leading providers of business and operational services, Parallon is uniquely equipped to provide a broad spectrum of customized revenue cycle services.
Job Summary
The Revenue Integrity Team Lead (Clinical) is responsible for assisting Revenue Integrity Leadership with quality assessment and training of the clinical Revenue Integrity Department Staff.  Performs internal quality assessment reviews on all Revenue Integrity Analysts to ensure compliance with Company policies. Monitor and assist staff with claims in RI workflow tools for timely resolution resulting in appropriate reimbursement and data integrity.
Duties (included but not limited to)
  • Perform on-going quality assessments for the clinical staff in the Revenue Integrity Department to ensure accurate completion of accounts being held due to Company or payer edits according to Federal and Company regulations 
  • Act as a resource to clinical Revenue Integrity Analysts for  complicated cases, reimbursement and compliance information 
  • Assist RI Management with trending patterns and identify training and educational opportunities 
  • Assist RI Managers in developing action plans for RI Analyst improvement.
  • Assist Revenue Integrity Managers by delivering standardized approved training and education to the Revenue Integrity Analysts 
  • Assist in the development of standardized tools, resources and policies and procedures 
  • Assist management with monitoring of claim volumes in RI workflow tools to ensure accurate and timely resolution.
  • Conduct new clinical analyst orientation and training 
  • Work account edits as needed
  • Maintain up-to-date knowledge of regulatory changes impacting charging practices 
  • Meets with the RI Manager regularly to effectively communicate and resolve issues, set and prioritize goals, improve processes and review department reports
  • Assists with staff communication, providing updates, resolving issues, setting goals and maintaining standards
  • Assist the Manager in maintaining established departmental policies and procedures, objectives, patient, and customer service policies
  • Perform quality reviews as required by Parallon/SSC policy.
  • Work as a liaison between team members and SSC staff
  • Assist with payroll activities for team members (i.e., time cards, edit sheets)

RN or other advanced nursing degree required
Healthcare experience in an acute care hospital or coding experience preferred. Knowledge of CPT/HCPCS codes or experience in charging or performing charge reviews
Active Registered Nurse License or other advanced nursing license required
We offer training support, competitive salary and excellent benefits to include several insurance package options for Medical, Dental and Vision; Paid Time Off for vacation, sick leave and holidays, Employer-paid Short Term Disability, Company matching 401K and more!

Parallon is an Equal Opportunity Employer (EOE), minority/ female/ veteran/ disabled, offering a great work environment, challenging career opportunities, and competitive compensation.