Title: Billing Integrity Analyst RN Location: San Antonio, TX, United States Full-time • Work From Home business_center Finance Accounting Billing Claims and Revenue find_in_page Job ID: 4469518 Job Description: Introduction This Work from Home position requires that you live and will perform the duties of the position; within 60 miles of an HCA Healthcare Hospital (Our hospitals are located in the following states: FL, GA, ID, KS, KY, MO, NV, NH, NC, SC, TN, TX, UT, VA). Do you want to join an organization that invests in you as a Billing Integrity Analyst RN? 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. 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 Billing Integrity Analyst RN like you to be a part of our team. Job Summary and Qualifications The Billing Integrity Analyst Register Nurse (RN) is responsible for determining the appropriateness of patient charges, and Charge Description Master (CDM) assigned HCPCS/CPTs, by reviewing the medical record, facility protocol, and other applicable documentation. This review includes the verification of billing data for accuracy and completeness, following regulatory requirements, in order to resolve edits or exceptions detected during system processing of the claim in Patient Accounting, Relay Health or the payer. Applies modifiers when appropriate based on this review, and/or makes necessary adjustments to patient account charges and/or balances. Analyzes accounts for specialized billing requirements that require a review of the medical record documentation, regulatory information, and HCA standards. Uses clinical expertise when applicable to perform charge reviews and/or works on edits that are deemed appropriate for only an RN to be qualified to review and resolve. Combines or splits accounts as appropriate. Serves as a liaison between facilities Administration, Shared Services Center, and ancillary department directors regarding charging issues, clinical documentation issues and revenue opportunities. Provides charge review results and develops and coordinates educational in-services for facility staff related to charging/billing issues. Coordinates retrospective, concurrent, patient requested, and external billing audits. Reviews denial trends for documentation and charging opportunities. Serves as a primary contact for charge related SSC and facility inquiries and issues. In this role you will: - Analyze and resolve specific billing edits that require an RNs clinical expertise and that are delaying claims from processing in the Patient Accounting and/or Relay Health systems. This includes the verification (and/or correction) of billing data for accuracy and completeness, by following regulatory requirements, and reviewing the medical record, facility protocol, and other applicable documentation. This also includes the application of modifiers and condition codes, as appropriate. - Identify charging, coding, or clinical documentation issues and work with appropriate leadership and ancillary departments to resolve issues. - Perform charge audits reviews by verifying billing data as compared to documentation and making corrections in Patient Accounting as needed. - Analyze charge review findings, provide recommendations to facility ancillary department directors in order to improve documentation, charging flow, and accuracy. - Serve as chargemaster liaison to facilitate clinical department education on appropriate charging of CPT codes, Revenue Codes, and communicating with Ancillary Departments to resolve issues. Coordinates updates (activate, inactivate, modification) with Ancillary Departments as necessary - Performs assigned charge reviews (governmental, corporate, insurance defense, patient requested, collections, denials, focused review, SPAEs, cosmetics, etc.) by researching documentation, analyzing information, entering all corrections as needed and communicating error trends to provide process improvement opportunities. - Review Regulatory and Compliance Communications, applicable CMS transmittals, and Local Coverage Decisions (LCD). Assess impact to Billing Integrity procedures and implement changes as needed. Perform NCD LCD Coverage review when requested. - Participate in customer service events at the facility such as facility FECC Committee, new director onboarding, charge education and report charging issues as appropriate. Qualifications: - RN or other advanced nursing degree required - Active Registered Nurse License or other advanced nursing license required. Compact license for all states accepted. - Healthcare experience in an acute care hospital or coding experience preferred. Knowledge of CPT/HCPCS codes or experience in charging or performing charge reviews 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 Billing Integrity Analyst RN 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.

Experience: - 2 - 4 years of experience in Security Operation Center (SOC), Cyber Security, and Information Security within an enterprise environment. - Experience with Windows and Linux, server and application hardening process. - Experience supporting one or more information security technologies. - Mandatory experience in Azure, EDR, XDR (Crowdstrike, Windows Defender), SOAR, SIEM Tools (e.g., Splunk, Rapid7, ArcSight, McAfee Nitro), Palo Alto, Cisco and one of the following: IDS/IPS, database activity monitoring, multi-factor authentication, web content filtering, encryption, and encryption key management, DLP, change detection. - Working knowledge of TCP/IP stack & familiarity with common protocols e.g., HTTP, FTP, SMTP, DNS. - Familiarity with network and application threats such as DoS/DDoS, SQL injection, XSS, reconnaissance scanning, and methods to avoid detection. - Working knowledge of compliance, and regulatory requirements, such as Payment Card Industry (PCI), Sarbanes-Oxley (SOX), and Healthcare Information Privacy Protection Act (HIPAA). - Experience with vulnerability scanning tools such as Nessus, Acunetix, Qualys, or Metasploit a plus. - Have scripting experience with Bash, PowerShell, or Python and the ability to use these skills to aid in responding to incidents involving Windows, Linux, and Mac hosts. - Be familiar with the MITRE ATT&CK Framework and/or Cyber Kill Chain. - InfoSec certification are a plus such as CISSP, CompTIA Security+, GIAC Security Essentials, & CEH - Have strong oral and written communication skills Strong interpersonal and leadership skills. Responsibilities: - Triage security incidents identified by SOC analysts. - Identify enhancement to rule sets and other tool optimization to automate reporting and reduce false positives in unified SIEM and review with manager / senior team members for implementation. - Coordinate with SOC manager to escalate security issues to other business units including solutions development, customer hosting and corporate IT. - Collaborate with business units to prioritize vulnerability remediation and execution of planned activities. - Subscribe to threat intelligence services and monitor vendor alerts for major vulnerability disclosures. - Monitoring of advanced security tools, perform analysis of dissimilar indicators, correlation of multiple sources, alert & coordination of security incidents across the environment. - Review & analyze system logs and third-party management products to preemptively detect, take defined corrective actions and alert process/system owners to new issues. - Assist with creation and maintenance of security incident response procedures. - Participate in research and assist implementation of security tools used by SOC team. - Assist SOC manager with dashboards and business reporting. - Ready to work in rotational 24/7 shift.

Altamira is a software development outsourcing company. We provide solutions that make a tangible impact on our client’s growth and productivity. With domain knowledge across product and technology development, we aim to provide cost-efficient solutions without compromising quality. We are driven to deliver the best, every single time. Altamira service delivery teams currently span Slovakia, Ukraine, and the Middle East, and we have ambitions to expand our footprint to meet the growing demand across Europe and into our primary growth markets in the UK and the US. In terms of industry verticals, we are focused on EdTech, Fintech, eCommerce, and Pharma. We are looking for a Data & Reporting Analyst to join our team. In this role, you will be responsible for maintaining data integrity, automating reporting workflows, and providing actionable insights through SQL and BI tools to support our client operations. Requirements - SQL Proficiency: Strong experience writing and optimizing queries in MySQL; familiarity with MySQL Workbench. - Python Knowledge: Ability to run and monitor Python scripts for data automation and ETL tasks. - BI & Visualization: Proven experience with Tableau (dashboard maintenance) and advanced MS PowerPoint for business reporting. - Data Accuracy: High level of attention to detail with experience in data validation and resolving data discrepancies. - Analytical Skills: Background in financial or usage reporting, including billing tracking and feature audits. - Language: Upper-Intermediate English (both written and verbal) for generating client-facing reports. Responsibilities - Download and manage recurring and ad‑hoc reports for all client accounts. - Execute data uploads using pre‑built Python scripts, ensuring correct account, billing period, and file inputs. - Run SQL inquiries against MySQL databases to support ad‑hoc reporting, usage analysis, zero‑usage reviews, feature audits, and installation and billing tracking. - Validate data integrity and ingestion results using MySQL Workbench. - Refresh Tableau dashboards and generate Client Service Reviews (CSRs) and PPT management reports. - Identify and resolve any data and process issues (e.g., reruns, file corrections, validation checks) and escalate complex issues appropriately. Our transparent recruitment journey usually takes up to 2 weeks and includes a few stages: - Recruiting Interview -> 30-45 min - Technical Interview -> 1-1,5h - Client Interview (optional) -> up to 1h - Pre-Offer Call -> 15min - Reference Check - Offer We offer: - Competitive salary, room for development and growth. - Possibility to work in the Bratislava and Kyiv offices or fully remotely. - Loyal management, interesting tasks, constant support. - Medical insurance (optional). - English courses. - Technical equipment providing. - Paid vacations 20 workdays, paid sick leave, regular salary reviews; - Flexible schedule and ability to manage your working hours; - Support your personal growth and skills upgrading. - The great environment inside the team, support of initiatives, and ability to contribute to the common goal. We do believe that the success of altamira.ai is impossible without the success of our Talents and the success of our Clients!

• Audit invoices and billing statements for accuracy, completeness, and compliance with company policies and contractual terms. • Identify discrepancies, errors, or inconsistencies in billing data and resolve them promptly. • Collaborate with billing, accounts receivable, and customer service teams to investigate and correct billing issues. • Maintain detailed records of audit findings and corrective actions. • Prepare audit reports and summaries for management review. • Monitor billing processes to ensure adherence to internal controls and regulatory standards. • Assist in the development and implementation of billing audit procedures and best practices. • Support internal and external audits by providing documentation and explanations as needed. • Analyze billing trends and patterns to detect potential fraud, overcharges, or underbilling. • Recommend process improvements to enhance billing accuracy and efficiency. • Ensure timely follow-up on audit findings and track resolution progress. • Validate billing data against contracts, service agreements, and purchase orders. • Coordinate with IT or systems teams to troubleshoot billing system issues or data mismatches. • Train and support billing staff on compliance standards and audit procedures. • Stay current with industry regulations, billing standards, and best practices.