Description
Introduction
Do you have the career opportunities as a Regulatory Compliance Senior Consultant you want with your current employer? We have an exciting opportunity for you to join HCA Healthcare which is part of the nations leading provider of healthcare services, HCA Healthcare.
Benefits
HCA Healthcare 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
Note: Eligibility for benefits may vary by location.
Our teams are a committed, caring group of colleagues. Do you want to work as a Regulatory Compliance Senior Consultant where your passion for creating positive patient interactions is valued? If you are dedicated to caring for the well-being of others, this could be your next opportunity. We want your knowledge and expertise!
Job Summary
As a Billing/Coding Senior Consultant on the Regulatory Compliance team, you will collaborate with facilities/entities within the Company to evaluate and provide billing and coding support, focusing on areas where significant data discrepancies are identified. Your primary responsibility will be to research, evaluate, and proactively identify outliers related to billing and coding information, based on established coding and billing guidelines. The ideal candidate will possess extensive billing and coding experience related to both inpatient and outpatient services. Furthermore, you should be adept at reviewing and communicating current and anticipated future regulatory provisions related to billing and coding, with the ability to convey technical requirements clearly to individuals without specialized expertise.
Major Responsibility:
- Identify significant outliers and collaborate with facilities/entities to evaluate and document the underlying causes.
- Direct and follow up on corrective actions as necessary to resolve identified issues.
- Provide comprehensive education and support regarding billing, coding, and regulatory changes to ensure compliance.
- Support and/or lead special projects, offering expertise from a coding and billing compliance perspective.
- Serve as a valuable resource for Corporate, Hospital, and Parallon colleagues, offering guidance and support.
- Demonstrate leadership through innovation, knowledge sharing, and best practices when collaborating with customers and peers.
- Apply in-depth knowledge of billing and coding guidelines, coupled with effective communication and listening skills, to address complex issues.
- Proactively assist the Company by evaluating key risk areas, such as PEPPER reports and industry/internal data analytics, and providing expert review of technical billing and technical requirements.
- Perform detailed data analysis using both Company and industry data to identify trends and potential areas of concern.
- Evaluate payer-specific coding guidelines and/or policies upon request, ensuring accurate and compliant billing practices.
- Conduct thorough research, evaluation, and proactive identification of outliers related to billing and coding information to ensure accuracy and compliance.
- Evaluate and document the root causes of identified outliers, providing clear and concise explanations.
- Follow up on corrective actions as needed, ensuring timely resolution of issues and preventing recurrence.
- Provide comprehensive education and assistance regarding billing, coding, and regulatory changes, keeping colleagues informed and compliant.
- Support and/or lead special projects from a coding and billing compliance perspective, offering expertise and guidance.
- Serve as a valuable resource for colleagues, providing support and guidance on complex billing and coding matters.
Education & Experience:
- Minimum of seven (7) years’ experience in hospital coding, revenue cycle, or other related healthcare experience required, demonstrating a deep understanding of the healthcare industry.
- Experience in a leadership role. Preferred
- Bachelors degree or equivalent combination of education and/or experience, providing flexibility for candidates with diverse backgrounds.
- Solid background in billing and coding practices, with a strong understanding of industry standards.
- Comprehensive knowledge of billing and coding guidelines and regulations, ensuring compliance with legal requirements.
- In-depth understanding of hospital/coding operations, workflows, and billing/revenue cycle processes, facilitating efficient and accurate billing practices.
Licenses, Certifications & Training:
- Healthcare Billing Training
- Registered Health Information Technician/Administrator certification Preferred
- Certified Coding Specialist (CCS) certification Preferred
- Health Care Compliance Association (HCCA) certification Preferred
- Certified Compliance & Ethics Professional (CCEP) or similar certification preferred.
Additional Information:
- This role will require up to 25% of travel.
We are comprised of affiliated hospitals, physician practices and other sites of care across the United States and United Kingdom. The Sarah Cannon Cancer Network is transforming cancer care through integrated services and cutting-edge technologies. Our physicians can develop leading oncology programs to advance science and patient care. Providing physician-led patient care offers our doctors access to a national network of experts. This is where multidisciplinary teams come together with a goal of delivering seamlessly coordinated, quality cancer care. Through a united network of globally recognized oncology specialists, we collaborate and share best practices. We address each aspect of the cancer journey, from screening and diagnosis through treatment and survivorship, to advance our shared mission: Above all else, we are committed to the care and improvement of human life.
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.
"Bricks and mortar do not make a hospital. People do."- Dr. Thomas Frist, Sr.
HCA Healthcare Co-Founder
If you are looking for an opportunity that provides satisfaction and personal growth, we encourage you to apply for our Regulatory Compliance Senior Consultant opening. We promptly review all applications. Highly qualified candidates will be contacted for interviews. Unlock the possibilities and apply today!
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.
