Manager Revenue Compliance - Parallon at Franklin

Job Description

Job: Finance Acctg Billing Claims & Revenue

Parallon, based in Franklin, Tennessee is a recently formed subsidiary of Hospital Corporation of America (HCA) and provides healthcare organizations with financial management, supply chain, purchasing, I.T. and staffing services that allow those organizations to concentrate on providing high quality patient care. Over the past 12 years, Parallons shared service solutions have been developed and proven in 250 hospitals and 2,000 non-acute care providers across the country. Through its five business units, Parallon provides complete revenue cycle and business process expertise, workforce management, supply chain and I.T. services along with the purchasing power of HealthTrust Purchasing Group that serve approximately 1,400 hospitals and 11,000 non-acute care providers. Parallon has a team of nearly 25,000 dedicated people who are committed to serving the needs of the healthcare industry.

The Manager of Revenue Compliance is the designated subject matter expert for chargemaster matters. This manager develops, implements and manages the Parallon Compliance program pertaining to chargemaster content under the supervision of the Director of Revenue Compliance. This individual will monitor regulatory updates which impact chargemaster maintenance, conduct focused reviews of chargemaster data, and assist with day-to-day revenue compliance support.

Key Responsibilities:

• Assist with Director of Revenue Compliance with the development of chargemaster related policies and procedures for Shared Services centers in accordance with payer and compliance requirements.
• Provide support and guidance to the SSC Chargemaster Managers on chargemaster related matters.
• Provide support and guidance to the SSC Chargemaster Managers and Supply Revenue Analysts related to the Supply Item Charge Attribute Master (SICAM). This includes conducting regular conference calls, making adjustments to the SICAM database when warranted, and reviewing chargemaster vendor recommendations.
• Maintain strictest confidentiality to ensure that privileged and/or proprietary information is adequately safeguarded against disclosure and that records are properly retained.
• Practice and adhere to the Code of Conduct philosophy and Mission and Values Statement.

Duties (included but not limited to):

• Monitor regulatory updates, payer communications and communications from HCA Regulatory Compliance Support and communicate relevant changes to the Director.
• Formulate responses to compliance questions from customers.
• Assist in the development of revenue compliance standards including policies, procedures, tools and educational documents.
• Develop agendas and conduct monthly conference calls with the SSC Chargemaster Managers.
• Perform due diligence to identify root causes for compliance issues which may correlate with revenue compliance procedures.
• Assist the Director in providing chargemaster and charge capture support to Shared Services Center chargemaster departments.
• Compile reports to identify potential revenue compliance issues, analyze data and identify issues, make recommendations for issue resolution.
• Perform focused audits and compile findings for the Director of Revenue Compliance.
• Perform other related functions as assigned.

Job Requirements

Associates degree required, Bachelors Degree preferred. Equivalent work experience may substitute degree requirement. LPN, LVN or RN preferred. Minimum three years healthcare revenue cycle experience required. Minimum three years compliance related experience in a healthcare setting. Experience in HCA financial, operational and system processes related to charging and A/R management preferred. Strong knowledge of HCPCS and modifier coding structure.

Country: USA, State: Tennessee, City: Franklin, Company: HCA Healthcare.