HCA Management Services, LP
Richmond, VA, United States
Revenue Integrity Team Lead Clinical – Work From Home – Full Time
/Parallon believes that organizations that continuously learn and improve will thrive. That’s why after more than a decade we remain dedicated to helping hospitals and hospital systems operate knowledgeably, intelligently, effectively and efficiently in the rapidly evolving healthcare marketplace, today and in the future. As one of the healthcare industry’s leading providers of business and operational services, Parallon is uniquely equipped to provide a broad spectrum of customized revenue cycle services./
The Revenue Integrity Team Lead (Clinical) is responsible for assisting Revenue Integrity Leadership with quality assessment and training of the clinical Revenue Integrity Department Staff. Performs internal quality assessment reviews on all Revenue Integrity Analysts to ensure compliance with Company policies. Monitor and assist staff with claims in RI workflow tools for timely resolution resulting in appropriate reimbursement and data integrity.
Duties (included but not limited to)
Perform on-going quality assessments for the clinical staff in the Revenue Integrity Department to ensure accurate completion of accounts being held due to Company or payer edits according to Federal and Company regulations
Act as a resource to clinical Revenue Integrity Analysts for complicated cases, reimbursement and compliance information
Assist RI Management with trending patterns and identify training and educational opportunities
Assist RI Managers in developing action plans for RI Analyst improvement.
Assist Revenue Integrity Managers by delivering standardized approved training and education to the Revenue Integrity Analysts
Assist in the development of standardized tools, resources and policies and procedures
Assist management with monitoring of claim volumes in RI workflow tools to ensure accurate and timely resolution.
Conduct new clinical analyst orientation and training
Work account edits as needed
Maintain up-to-date knowledge of regulatory changes impacting charging practices
Meets with the RI Manager regularly to effectively communicate and resolve issues, set and prioritize goals, improve processes and review department reports
Assists with staff communication, providing updates, resolving issues, setting goals and maintaining standards
Assist the Manager in maintaining established departmental policies and procedures, objectives, patient, and customer service policies
Perform quality reviews as required by Parallon/SSC policy.
Work as a liaison between team members and SSC staff
Assist with payroll activities for team members (i.e., time cards, edit sheets)
RN or other advanced nursing degree required
Healthcare experience in an acute care hospital or coding experience preferred. Knowledge of CPT/HCPCS codes or experience in charging or performing charge reviews
Active Registered Nurse License or other advanced nursing license required
We offer training support, competitive salary and excellent benefits to include several insurance package options for Medical, Dental and Vision; Paid Time Off for vacation, sick leave and holidays, Employer-paid Short Term Disability, Company matching 401K and more!
Parallon is an Equal Opportunity Employer (EOE), minority/ female/ veteran/ disabled, offering a great work environment, challenging career opportunities, and competitive compensation.
Job: *Supervisors Team Leaders & Coordinators
Title: Revenue Integrity Team Lead Clinical
Location: Virginia-Richmond-RI - Richmond
Requisition ID: 25727-166228
HCA Management Services, LP
Website : http://hcahealthcare.com
At its founding in 1968, Nashville-based HCA was one of the nation's first hospital companies. Today, we are the nation's leading provider of healthcare services, a company comprised of locally managed facilities that includes about 165 hospitals and 115 freestanding surgery centers in 20 states and England and employing approximately 204,000 people. Approximately four to five percent of all inpatient care delivered in the country today is provided by HCA facilities. Milton Johnson serves as Chairman and Chief Executive Officer of HCA. HCA is committed to the care and improvement of human life and strives to deliver high quality, cost effective healthcare in the communities we serve. Building on the foundation provided by our Mission & Values, HCA puts patients first and works to constantly improve the care we give them by implementing measures that support our caregivers, help ensure patient safety and provide the highest possible quality. Investing in our communities is important to us. HCA typically invests about $1.5 billion annually to keep our facilities modern and up-to-date technologically and to expand and add services where needed. Focusing primarily on communities where the company is a leading healthcare provider, HCA selectively adds new facilities in order to better serve our communities. And because two HCA founders were physicians, we value highly the strong relationships we've created with local physicians. We endeavor to provide them with a wide array of services and modern facilities in order to help them deliver the best possible care.