Medical Coding Specialist for Revenue Integrity

5 days ago


Nashville, Tennessee, United States HCA Full time
About the Role

We are seeking a highly skilled Medical Coding Specialist to join our team in Revenue Integrity. In this role, you will play a critical part in ensuring accurate and compliant coding practices across our facilities.

Key Responsibilities:

  • Determine the appropriateness of patient charges by reviewing medical records, facility protocols, and corporate standards
  • Provide charge review results and develop educational in-services for facility staff on 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 on charging issues and revenue opportunities

What You Will Do:

  • During the implementation of Meditech Expanse, be responsible for conversion-related charging activity, including mapping between Facility chargemaster and Meditech Expanse, concurrent charge reviews, and reconciliation of charging based on swings in gross charges
  • Constantly communicate with Facility Departments to address identified charging issues prior to and post go-live, ensuring the Facility CFO is kept up-to-date on progress related to charging activity
  • Consistently monitor charging practices across all facilities, including charge reviews, remedial training, and education
  • Provide education and training to Facility Departments on Charge Reconciliation reporting and perform oversight and trending of reporting on a monthly basis
  • Work directly with Facility Departments to provide education and support HCA charging practices and regulatory requirements
  • Develop chargemasters and charging practices for new service lines and procedures, using approved standardization guidelines and monitoring charging practices upon implementation
  • Serve as chargemaster liaison to facilitate clinical department education on appropriate CPT codes, Revenue Codes, and communication with Ancillary Departments to resolve issues
  • Review Regulatory and Compliance Communications, applicable CMS transmittals, and Local Coverage Decisions (LCD) and assess their impact on Revenue Integrity procedures, implementing changes as needed
  • Contribute to Charge Optimization projects and support the Corporate RI team on special projects, charge reviews, and patient audits

Qualifications:

  • 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
  • Experience as a Coder with Revenue Integrity background preferred
  • Medical Necessity and Clinical Analysts experience preferred

About Parallon

Parallon provides full-service revenue cycle management 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. We also provide targeted solutions for external clients across the country.

About HCA Healthcare

HCA Healthcare has been recognized as one of the Worlds Most Ethical Companies by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.

Salary Range:$65,000 - $85,000 per year, depending on experience



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