Virtual Senior Appeals Analyst

HCA Nashville , TN 37201

Posted 6 days ago

Parallon believes that organizations that continuously learn and improve will thrive. That's why, after more than a decade, we remain dedicated to helping hospitals and hospital systems operate knowledgeably, intelligently, effectively and efficiently in the rapidly evolving healthcare marketplace, today and in the future. As one of the healthcare industry's leading providers of business and operational services, Parallon is uniquely equipped to provide a broad spectrum of customized revenue cycle services.

We are looking for a dynamic candidate to be part of our team. We offer excellent benefit packages, including 401K, bonus potential, tuition reimbursement, medical and dental plans, flexible spending plans, long-term/ short -term disability, and generous paid time off!

DUTIES INCLUDE BUT ARE NOT LIMITED TO:

  • Review technical and clinical denial arguments for reconsideration on top dollar accounts, including both written and telephonically through resolution process.

  • Identify contract protection that can be leveraged to overturn denials

  • Identify coding or clinical documentation issues and work to correct the errors in a timely manner

  • Serves as a subject matter expert in payer appeals resolution process

  • Identify problem accounts/processes/trends and escalate as appropriate

  • Overcome objections that prevent payment of the claim and gain commitment for payment through concise and effective appeal argument.

We are in need of an experienced Senior Appeals analyst. This position research and resolve high dollar technical and top dollar clinical appeals through concise understanding of payer contract language and clinical or technical justification. You need the following to be our top candidate:

  • Bachelor's degree required

  • Master's degree preferred

  • 2 year of related experience required

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Virtual Senior Appeals Analyst

HCA