Revenue Integrity Clin Charge Review Analyst RN

Grand Strand Medical Center - Myrtle Beach, SC

Part-time,Full-time - Mid Level

Remote - Myrtle Beach, SC

10,001+ employees

Hospitals

About the position

The Revenue Integrity Clinical Charge Review Analyst RN at HCA Healthcare is responsible for ensuring the appropriateness of patient charges by reviewing medical records and facility protocols. This role involves charge review results, educational coordination for facility staff, and monitoring denial trends to identify documentation and charging opportunities. The analyst serves as a liaison between various departments to address charging issues and enhance revenue opportunities.

Responsibilities

• Determine the appropriateness of patient charges by reviewing medical records and facility protocols.
• Provide charge review results and develop educational in-services for facility staff related to charging and billing issues.
• Review denial trends for documentation and charging opportunities.
• Serve as a liaison between facilities Administration, d Services Center, and ancillary department directors regarding charging issues.
• Manage conversion-related charging activities during Meditech Expanse implementation.
• Maintain communication with Facility Departments to address charging issues during Meditech Expanse implementation.
• Monitor charging practices across all facilities through charge reviews and remedial training.
• Provide education and training on Charge Reconciliation reporting to Facility Departments.
• Work with Facility Departments to educate on HCA charging practices and regulatory requirements.
• Collaborate with Facility Department Directors in developing chargemaster and charging practices for new service lines or procedures.
• Act as a liaison for clinical departments to facilitate education on appropriate charging of CPT codes and Revenue Codes.
• Review regulatory and compliance communications and assess their impact on Revenue Integrity procedures.
• Participate in charge optimization projects and support the Corporate Revenue Integrity team on special projects.

Requirements

• Registered Nurse Degree required.
• Minimum 1 year directly related Healthcare experience required.
• Knowledge of CPT/HCPCS codes or experience in charging or performing charging validation reviews preferred.

Nice-to-haves

• Experience in revenue cycle management or healthcare billing processes.

Benefits

• Comprehensive medical coverage with low copay options.
• Dental and vision benefits.
• Life and disability coverage.
• Flexible spending accounts.
• Supplemental health protection plans.
• Auto and home insurance options.
• Identity theft protection and legal counseling.
• Long-term care coverage and moving assistance.
• Pet insurance and free counseling services.
• 401(k) Plan with a 100% match on contributions.
• Employee Stock Purchase Plan with discounts.
• Fertility and family building benefits.
• Referral services for various personal needs.
• Consumer discounts and education assistance programs.
• Colleague recognition program and paid time off options.