HCA, Hospital Corporation of America Compliance Manager for Hospital System in Irving, Texas
Parallon's Mission: /We serve and enable those who care for and improve human life in their communities./
Parallon, a division of HCA, is an industry-leading provider of patient financial and revenue cycle services to acute care providers across the United States.
The Compliance and Charge Master Manager is primarily responsible for* *ensuring the integrity of Charge Master and related processes and assisting the ECO with the management of compliance-related initiatives.
This position requires experience in the hospital business, either in a shared services center environment or within the actual hospital. Experience in other industries is not relevant enough for consideration in this role.
This individual will lead three Charge Master Support Analyst(s) and four Compliance Analysts.
DUTIES INCLUDE BUT ARE NOT LIMITED TO: · Ensure proper maintenance of Charge Master and related processes · Review Charge Master in cooperation with outside vendor, Health Information Management, Billing, Ancillary Department heads, Finance and Administration to ensure compliance and appropriate statement of revenue · Evaluate current charge mechanisms and systems (e.g. OR module, Smart, Accudose, Pyxis, OEP) to assess efficiency and effectiveness of charge capture · Coordinate with department managers to identify trends and address issues related to appropriate charge capture Analyze Charge Master statistics on monthly basis and perform associated analyses Review results of periodic audits and take appropriate action as indicated · Assist the ECO with completion of periodic reviews, audits and other requirements outlined in the ECO Functional Standards · Perform research and analysis on corporate and federal payer rules, regulations and transmittal; and communicate requirements to operational areas · Manage the daily operations of the Privacy Program including investigation and timely reporting of privacy issues. · Review internal communications including those from Corporate Parallon and HCA, assess operational impact and provide education to operational leadership · Work with facilities on audit and re-bill projects related to potential governmental over-payment issues · Assist with processing of Risk Management/Quality of Care incidents
EXPERIENCE · Reporting and analyzing revenue cycle key performance indicators · Working knowledge of reimbursement methodology, coding, CPT/HCPC, charge capture and billing processes · Ability to interpret managed care contracts · Working knowledge of regulatory compliance requirements · Experience with CDM preferred
EDUCATION Minimum, undergraduate degree or pending degree program from an accredited institution
Title: Compliance Manager for Hospital System
Location: Texas-Irving-PAS - Dallas
Requisition ID: 08950-113862