Business Integrity Analyst Credentialed

Job Summary and Qualifications Experience the HCA Healthcare difference where colleagues are trusted, valued members of our healthcare team. Grow your career with an organization committed to delivering respectful, compassionate care, and where the unique and intrinsic worth of each individual is recognized. Business Integrity Analyst Credentialed – a work‑from‑home position requiring residency within 60 miles of an HCA Healthcare hospital (states: FL, GA, ID, KS, KY, MO, NV, NH, NC, SC, TN, TX, UT, VA). The Billing Integrity Analyst (Credentialed) determines the appropriateness of patient charges and Charge Description Master (CDM) assigned HCPCS/CPTs by reviewing the medical record, facility protocol, and other documentation. The role verifies billing data for accuracy and completeness, follows regulatory requirements, resolves edits or exceptions detected during system processing of claims in Patient Accounting, Relay Health, or the payer system, and serves as a primary contact for charge‑related SSC and facility inquiries. Responsibilities Analyze and resolve billing edits that require HCPCS/CPT coding expertise, including modifier and condition code application as needed. Identify charging, chargemaster coding, or clinical documentation issues and collaborate with leadership and ancillary departments to resolve them. Act as charge master liaison to educate clinical departments on appropriate CPT and revenue code usage, and coordinate updates with ancillary departments. Review regulatory and compliance communications, CMS transmittals, and Local Coverage Decisions, assessing impact to Billing Integrity procedures and implementing changes. Maintain billing education by attending webcasts and conference calls as required. Qualifications Associate degree or higher; or a relevant healthcare license/certification. Minimum one year of directly related healthcare or coding experience. Knowledge of CPT/HCPCS codes or experience in charging validation reviews preferred. Healthcare certifications such as RHIT, CCS, CCP, CPC, LPN, LVN, RT, PT, or other AHIMA‑certified coding credentials are acceptable in lieu of a degree with work experience. Benefits Comprehensive benefits for medical, prescription drug, dental, vision, behavioral health, and telemedicine services. Well‑being support, including free counseling and referral services. Time‑off programs: paid time off, paid family leave, short‑ and long‑term disability coverage, and leaves of absence. Retirement resources: 401(k) plan with 100% match on 3% to 9% of pay, Employee Stock Purchase Plan, flexible spending accounts, and financial wellness counseling. Education support: tuition assistance, student loan assistance, certification support, and a partnership with Galen College of Nursing. Additional benefits: fertility and family‑building assistance, adoption support, life insurance, supplemental health protection plans, auto and home insurance, legal counseling, identity theft protection, and consumer discounts. Learn more about Employee Benefits ( 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. #J-18808-Ljbffr HCA Healthcare