Revenue Integrity Clin Charge Review Analyst RN

St. David's Healthcare Partnership - Austin, TX

Part-time,Full-time - Mid Level

Austin, TX

10,001+ employees

Hospitals

About the position

The Revenue Integrity Clinical Charge Review Analyst RN at St. David's South Austin Medical Center 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 position requires up to 60% travel and plays a crucial role in maintaining compliance with HCA and regulatory standards while supporting the implementation of Meditech Expanse.

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, Shared 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 implementation.
• Monitor charging practices across all facilities through charge reviews and training.
• Provide education and training on Charge Reconciliation reporting and analyze monthly reporting trends.
• Collaborate with Facility Department Directors to develop chargemaster and charging practices for new service lines.
• 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 implement necessary changes to 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 with Meditech Expanse implementation.
• Familiarity with regulatory compliance communications.

Benefits

• Employee stock purchase plan
• Disability insurance
• Health insurance
• Dental insurance
• Flexible spending account
• Tuition reimbursement
• Paid time off
• Adoption assistance
• Family leave
• Vision insurance
• 401(k) matching
• Pet insurance