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Senior Underpayment Analyst

1 month ago

St Petersburg, United States Parallon Full time

Description

Introduction

Last year our HCA Healthcare colleagues invested over 156,000 hours volunteering in our communities. As a Senior Underpayment Analyst with Parallon you can be a part of an organization that is devoted to giving back

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.

Would you like to unlock your potential with a leading healthcare provider dedicated to the growth and development of our colleagues? Join the Parallon family We will give you the tools and resources you need to succeed in our organization. We are looking for an enthusiastic Senior Underpayment Analyst to help us reach our goals. Unlock your potential

Job Summary and Qualifications

As a Senior Underpayment Analyst, you will research and resolve high dollar insurance payer underpayments through concise understanding of payer contract language and respective payment calculation. Position requires individuals with high mathematical acumen, ability to access and assimilate data, articulate a strong case, confidence and strong persuasion skill set. Results oriented individual will be required to work through various options available to liquidate the most difficult high dollar underpayments. Candidate will demonstrate ability to grow strategic payer relationships and obtain understanding of payer system to navigate through claims processing centers. Critical thinking skills are necessary, as well as ability to see trends that require escalation to the Payment Compliance Director. Responsible for bundling similar cases not resolved through the standard Payment Compliance process and escalate to Dispute Resolution Team for legal action.

In this role you will:

  • Analyzes hospital claims to identify contractual underpayments or billing errors.

  • Resolves underpaid claims from various payer products including HMO, PPO, Medicaid, Medicare and Workers' Compensation.

  • Articulates contract provisions to representatives from healthcare payer companies and government agencies.

  • Contacts payer companies via phone or correspondence and initiates request for payment.

  • Performs appropriate follow up with Payer and gains commitment for payment.

  • Escalates Payer lack of response and/or lack of payment within Payer organization as appropriate.

  • Identifies and communicates contract interpretation issues and language discrepancies to leadership as appropriate.

  • Identifies Payer company trends and communicates trends to supervisor for further action/escalation.

  • Serves as a subject matter expert in Payer contract dispute resolution process.

What qualifications you will need:

  • Bachelors degree required. Masters degree preferred.

  • Two years of related experience preferred.

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 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.

"There is so much good to do in the world and so many different ways to do it."- Dr. Thomas Frist, Sr.
HCA Healthcare Co-Founder

Be a part of an organization that invests in you We are reviewing applications for our Senior Underpayment Analyst opening. Qualified candidates will be contacted for interviews. Submit your application and help us raise the bar in patient care

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.

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