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Prebill Denials Analyst - Work From Home

Company: Parallon
Location: Bowling Green
Posted on: June 14, 2019

Job Description:

DescriptionSHIFT: Work From Home

SCHEDULE: Full-timePrebill Denials Analyst - Work From Home -

Full-Time

Parallon is an affiliate of Hospital Corporation of America (HCA Holdings, Inc.) and is a

leading provider of healthcare business and operational services. Parallon

supports healthcare providers in the area of revenue cycle (billing,

collections, denial management), technology, patient registration, insurance

verification and health information management.

JOB SUMMARY:

The Prebill

Denials Analyst will review post discharge, prebill accounts that do not have

an authorization on file, ALOS versus days authorized variances, and/or other

account discrepancies identified that will result in the account being denied

by the payor that do not require a clinical review. Communicates with third

party payors to resolve discrepancies prior to billing. Accurately and

concisely documents all communications and action taken on the account in

accordance with policies and procedures. The Prebill Denials Analyst will

escalate medical review request and/or denial activities to the Prebill Denials

Nurse.

DUTIES

(included but not limited to):



  • Work

    prebill accounts imported into the PDU Tool efficiently and effectively on a

    daily basis to resolve accounts with "no auth numbers and ALOS vs. authorized

    days variances
  • Work

    assigned accounts in eRequest to resolve outstanding issues
  • Report

    insurance denial trends identified during daily operational assignments
  • Identify

    problem accounts and escalate as appropriate
  • Document

    actions taken on the account clearly and concisely
  • Contacting

    the facilities, physicians' offices and/or insurance companies to resolve

    denials/appeals
  • Adhere

    to time and attendance policies
  • Adhere

    to all policies and procedures, including phone and internet usage, break

    utilization, etc.
  • Participate

    in ongoing education and training as needed
  • Establish

    and maintain relationships with all customers
  • Seeks

    assistance from immediate supervisor when in situations which are unclear or

    ambiguous
  • Adheres

    to established policy and procedure and escalates issues through the

    established Chain of Command
  • Demonstrates

    commitment to teamwork and cooperation
  • Practice

    and adhere to the "Code of Conduct" philosophy and "Mission and Value

    Statement"
  • Other

    duties as assigned

    KNOWLEDGE, SKILLS & ABILITIES:


    • Communication



      • communicates clearly


        and concisely, verbally and in writing. This includes utilizing proper

        punctuation, correct spelling and the ability to transcribe accurately.
      • Customer

        orientation -

        establishes and maintains long-term customer relationships, building trust and

        respect by consistently meeting and exceeding expectations.
      • Interpersonal

        skills - able to work

        effectively with other employees, patients and external parties
      • PC

        skills - demonstrates

        proficiency in Microsoft Office applications and others as required
      • Policies

        & Procedures -

        demonstrates knowledge and understanding of organizational policies, procedures

        and systems
      • Basic

        skills - demonstrates

        ability to organize, perform and track multiple tasks accurately in short

        timeframes, have ability to work quickly and accurately in a fast-paced

        environment while managing multiple demands, ability to work both independently

        and collaboratively as a team player, adaptability, analytical and problem

        solving ability and attention to detail and able to perform basic mathematical

        calculations, balance and reconcile figures, punctuate properly, spell

        correctly and transcribe accurately.


        Qualifications

        EDUCATION:

        • High

          school diploma or GED required.

          EXPERIENCE:


          • One year of related experience required
          • Experience in the following areas: appeals,

            denials, managed care, verifications/notification, precertification experienced

            preferred


            We offer training

            support, competitive salary and excellent benefits to include several insurance

            package options for Medical, Dental and Vision; Paid Time Off for vacation,

            sick leave and holidays, Employer-paid Short Term Disability, Company matching

            401K and more!

            Parallon is an Equal Opportunity Employer (EOE), minority/ female/ veteran/

            disabled, offering a great work environment, challenging career opportunities,

            and competitive compensation.

            #PARALLONBCOM

Keywords: Parallon, Bowling Green , Prebill Denials Analyst - Work From Home, Professions , Bowling Green, Kentucky

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