REVENUE INTEGRITY ANALYST – WFH
Date Posted: 1/8/2018
Employee Type: Full-Time
Location: Richmond, VA
Job Type: Other
Experience: Not Specified
Parallon is seeking a self-motivated individual for our Revenue Integrity Analyst role. This is a work from home position with full-time hours.
Job Summary ? The Revenue Integrity Analyst (non clinical and non certified) assist in resolving billing edits that are holding patient claims from billing by reviewing medical records and other applicable documentation. Assist in reviewing 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. Makes necessary adjustments to patient account charges based on regulatory and payor guidelines. Analyzes accounts for specialized billing requirements that require a review of the medical record documentation, regulatory information, and HCA standards. 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.
Duties (included but not limited to):
Analyze and resolve specific billing edits that require understanding of claims level edits that are delaying claims from processing in the Patient Accounting and/or SSI systems. This includes the verification (and/or correction) of billing data for accuracy and completeness, by following regulatory requirements, and reviewing the medical record, facility protocol, and other applicable documentation.
Identify charging or clinical documentation issues and work with appropriate leadership and ancillary departments to resolve issues.
Review all regulatory and Parallon compliance correspondence and adheres to all guidelines
Serve as chargemaster 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
Review HCA Regs Communications, applicable CMS transmittals, and Local Coverage Decisions (LCD). Assess impact to Revenue Integrity procedures and implement changes as needed.
Participate as a member of the facility FECC Committee and report charging issues as appropriate.
Maintain billing education, attend webcasts and conference calls as required.
Maintain mandated education and attend necessary webcasts/conference calls
Oversee assignment of observation and injection/infusion charges, as applicable to SCC
Practice and adhere to the ?Code of Conduct? philosophy and ?Mission and Value Statement?.
Other duties as assigned
High school diploma or GED required.
One year of related experience required.
Medical Billing , Analyst
To apply for this job please visit the following URL: https://careers.parallon.com/en-US/job/revenue-integrity-analyst-wfh/J3M1KN63MK1WG96LXYT →