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Senior Appeals Analyst
4 months ago
Description
IntroductionDo you have the career opportunities as a Senior Appeals Analyst you want with your current employer? We have an exciting opportunity for you to join Parallon which is part of the nations leading provider of healthcare services, HCA Healthcare.
BenefitsParallon, 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 Senior Appeals Analyst where your passion for creating positive patient interactions are 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 and QualificationsSeeking a Senior Appeals Analyst who will research and resolve High Dollar Technical and Top Dollar Clinical Appeals through understanding of Payer Contract Language and Clinical or Technical justification. You will also be responsible for compiling similar unresolved cases and escalating to the Dispute Resolution Team for legal action. We are an amazing team that works hard to support each other and are seeking phenomenal addition like you. We want you to apply today
What you will do in this role:
Review technical and clinical denial arguments for reconsideration on top dollar accounts
Identify coding or clinical documentation issues and work to correct the errors in a timely manner
Identify contract protection that can be leveraged to overturn denials
Overcome objections that prevent payment of the claim and gain commitment for payment through concise and effective appeal argument
Identify problem accounts/processes/trends and escalate as appropriate
You will identify and communicate contract interpretation issues and language discrepancies to leadership as appropriate
You will identify payer company trends and communicate them to the supervisor for further action.
You will serve as subject matter expert in the payer appeals resolution process
What qualifications you will need:
Bachelor's Degree required, Master's degree preferred
At least 2 years of related experience
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.
"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 Senior Appeals Analyst 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 and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.
