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Description

Introduction

Do you want to join an organization that invests in you as a Revenue Integrity Clinical Team Lead? At Parallon, you come first. HCA Healthcare has committed up to $300 million in programs to support our incredible team members over the course of three years.

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 medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.

+ Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.

+ Free counseling services and resources for emotional, physical and financial wellbeing

+ 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)

+ Employee Stock Purchase Plan with 10% off HCA Healthcare stock

+ Family support through fertility and family building benefits with Progyny and adoption assistance.

+ Referral services for child, elder and pet care, home and auto repair, event planning and more

+ Consumer discounts through Abenity and Consumer Discounts

+ Retirement readiness, rollover assistance services and preferred banking partnerships

+ Education assistance (tuition, student loan, certification support, dependent scholarships)

+ Colleague recognition program

+ Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)

+ Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.

Learn more about Employee Benefits (https://careers.hcahealthcare.com/pages/employee-benefits-and-rewards)

_Note: Eligibility for benefits may vary by location._

You contribute to our success. Every role has an impact on our patients’ lives and you have the opportunity to make a difference. We are looking for a dedicated Revenue Integrity Clinical Team Lead like you to be a part of our team.

Job Summary and Qualifications

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.

What you will do in this role:

+ 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 identifies 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

+ Openly communicate issues and opportunities to appropriate person(s)

+ 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

+ Escalate issues appropriately

+ Meet all educational requirements as assigned by management and HCA

+ 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)

+ Assist manager with developing team goals and action plans

+ Practice and adhere to the “Code of Conduct” philosophy and “Mission and Value Statement”

+ Other duties as assigned

What qualifications you will need:

+ 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.

**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. We also provide full-service revenue cycle management as well as targeted solutions, such as Medicaid Eligibility, for external clients across the country. Parallon has over 17,000 colleagues, and serves close to 1,000 hospitals and 3,000 physician practices, all making an impact on patients, providers, and their communities.

HCA Healthcare has been recognized as one of the World's 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.

"Good people beget good people."- Dr. Thomas Frist, Sr.

HCA Healthcare Co-Founder

We are a family 270,000 dedicated professionals! Our Talent Acquisition team is reviewing applications for our Revenue Integrity Clinical Team Lead opening. Qualified candidates will be contacted for interviews. **Submit your resume today to join our community of caring!**

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.