Business Integrity Analyst Credentialed

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

Do you have the career opportunities you want with your current employer? We have an exciting opportunity for you to join our Work from Home team, 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).

The Billing Integrity Analyst (Credentialed) 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, to resolve edits or exceptions detected during system processing of the claim in Patient Accounting, Relay Health or the payer. Serves as a primary contact for charge related SSC and facility inquiries and issues.

What you will do in this role:

• Analyze and resolve specific billing edits that require HCPCS/CPT coding based on the chargemaster expertise and that are delaying claims from processing in the Patient Accounting and/or Relay Health 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. This also includes the application of modifiers and condition codes, as appropriate.
• Identify charging, chargemaster coding, or clinical documentation issues and work with appropriate leadership and ancillary departments to resolve issues that are identified while working on edits.
• Serve as charge master 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 Regulatory and Compliance Communications, applicable CMS transmittals, and Local Coverage Decisions (LCD). Assess impact to Billing Integrity procedures and implement changes as needed.
• Maintain billing education, attend webcasts and conference calls as required.

What qualifications you will need:

• Associate degree or above; or healthcare license/certification required.
• Minimum 1 year directly related Healthcare experience or coding experience required.
• Knowledge of CPT/HCPCS codes or experience in charging or performing charging validation reviews preferred.
• Healthcare certification/licensure such as RHIT, CCS, CCP, CPC or other recognized AHIMA certified coding credential, LPN, LVN, RT, PT, etc., can be accepted in lieu of degree with work experience.

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.

Note: Eligibility for benefits may vary by location.

About Parallon and HCA Healthcare

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.

HCA Healthcare has been recognized as one of the World's Most Ethical Companies® by the Ethisphere Institute more than ten times.

If you are looking for an opportunity that provides satisfaction and personal growth, we encourage you to apply. We promptly review all applications. Highly qualified candidates will be directly contacted by a member of our team. We are interviewing - apply today!

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.