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SWAT Clinical Analyst

4 months ago


San Antonio, Texas, United States HCA Healthcare Full time

Description

Introduction

Are you looking for a work environment where diversity and inclusion thrive? Submit your application for our SWAT Clinical Analyst opening with Parallon today and find out what it truly means to be a part of the HCA Healthcare team.

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.

Learn more about Employee Benefits

Note: Eligibility for benefits may vary by location.

We are seeking a SWAT Clinical Analyst for our team to ensure that we continue to provide all patients with high quality, efficient care. Did you get into our industry for these reasons? We are an amazing team that works hard to support each other and are seeking a phenomenal addition like you who feels patient care is as meaningful as we do. We want you to apply

Job Summary and Qualifications

Seeking a SWAT Clinical Analyst who will assist in any operational area in which needs arise. 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:

Assist in any operational area in which needs arise.

Contact facilities, physicians' offices and/or insurance companies to resolve denials/appeals.

Analyze and resolve specific billing edits that require clinical expertise.

Ensure compliance with company and departmental policies and procedures.

Demonstrate understanding of Medical Necessity software, including but not limited to InterQual.

Perform charge audit reviews by verifying billing data as compared to documentation and making corrections in Patient Accounts.

Work as a liaison between various departments throughout the enterprise.

Identify problem account, processes or trends and escalate as appropriate.

Provide coverage as needed to appropriately manage departments' inventory.

Perform basic math to ensure accurate statement of accounts receivable.

Maintain working knowledge of workflow, systems, and tools used in the various departments.

What qualifications you will need:

Registered Nursing (RN) degree or Licensed Practical Nurse (LPN) certification and current licensure.

1 year of experience in Utilization Review, appeals, denials, and experience in performing charge reviews preferred; exceptions to be considered if candidate has skill set that can be applied across multiple departments.

Currently licensed as a RN or LPN in the state(s) of practice and/or as an active compact license, in accordance with law and regulation.

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.

"Across HCA Healthcare's more than 2,000 sites of care, our nurses and colleagues have a positive impact on patients, communities and healthcare.
Together, we uplift and elevate our purpose to give people a healthier tomorrow."- Jane Englebright, PhD, RN CENP, FAAN
Senior Vice President and Chief Nursing Executive

If you find this opportunity compelling, we encourage you to apply for our SWAT Clinical Analyst opening. We promptly review all applications. Highly qualified candidates will be directly contacted by a member of our team. We are interviewing 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.