Registered Nurse Analyst - Revenue Integrity - Work from Home in Richmond, VA at Parallon

Date Posted: 8/24/2018

Job Snapshot

Job Description

Revenue Integrity Analyst – Registered Nurse – Work from Home
 
Parallon is an affiliate of Hospital Corporation of America (HCA Holdings, Inc.) and is a leading provider of healthcare business and operational services.  Parallon supports healthcare providers in the areas of revenue cycle (billing, collections, and denial management), technology, patient registration, insurance verification, and health information management.
 
The Revenue Integrity Analyst Register Nurse (RN) is responsible for determining the appropriateness of patient charges, and Charge Description Master (CDM) assigned HCPCS/CPTs, by reviewing the medical record, facility protocol, and other applicable documentation. This review includes the 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. Applies modifiers when appropriate based on this review, and/or makes necessary adjustments to patient account charges and/or balances. Analyzes accounts for specialized billing requirements that require a review of the medical record documentation, regulatory information, and HCA standards. Uses clinical expertise when applicable to perform charge reviews and/or works on edits that are deemed appropriate for only an RN to be qualified to review and resolve. Combines or splits accounts as appropriate. Serves 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.


Must have current RN license.
 
Work from Home Requirements:
Internet Connectivity requirements - At a minimum
 
  • Cable or DSL (Digital Subscriber Line)
  • Minimum Download Speed1 MB/S
  • Minimum Upload Speed512 KB/S
  • Minimum Latencyunder 90ms 

Job Requirements

EDUCATION
  • RN or other advanced nursing degree

 
EXPERIENCE
  • Healthcare experience in an acute care hospital or coding experience preferred.  Knowledge of CPT/HCPS codes or experience in charging or performing charge reviews.

 
We offer a convenient location, free parking, training support, competitive compensation, and excellent benefits that include several insurance packages to choose from, paid time off for vacation, sick leave and holidays, company matching 401K.
 
Parallon is an Equal Opportunity Employer (EOE), minority/Female/Veteran/Disabled, offering a great work environment, challenging career opportunities, and competitive compensation.
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