Easter Seals Jobs

Description

Introduction

Last year our HCA Healthcare colleagues invested over 156,000 hours volunteering in our communities. As a Clinical Denials Coding Review Specialist with Work from Home you can be a part of an organization that is devoted to giving back!

Benefits

Work from Home, 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 (https://careers.hcahealthcare.com/pages/employee-benefits-and-rewards)

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 Work from Home family! We will give you the tools and resources you need to succeed in our organization. We are looking for an enthusiastic Clinical Denials Coding Review Specialist to help us reach our goals. Unlock your potential!

Job Summary and Qualifications

The Clinical Denials Coding Review Specialist is responsible for applying correct coding guidelines and payor requirements as it relates to researching, analyzing, and resolving outstanding clinical denials and insurance claims. This job requires regular outreach to payors and Practices.

What you will do in this role:

• Triage incoming inventory, validating appeal criteria is met in compliance with departmental policies and procedures

• Review Medicare Recovery Audit Contractor (RAC) recoupment requests and process or appeal as appropriate

• Compose technical denial arguments for reconsideration, including both written and telephonically

• 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

• Utilize effective documentation standards that support a strong historical record of actions taken on the account

• Post denials, post or correct contractual adjustments, and post other non-cash related Explanation of Benefits (EOB) information

• Update patient accounts as appropriate

• Submit uncollectible claims for adjustment timely and correctly

• Resolve claims impacted by payor recoupments, refunds, and posting errors

• Assist team members with coding questions and provide resolution guidance

• Provide coding guidance and support to Practices

• Meet and maintain established departmental performance metrics for production and quality

• Maintain working knowledge of workflow, systems, and tools used in the department

• Practice and adhere to the “Code of Conduct” philosophy and “Mission and Value Statement”

• Other duties as assigned

Requirements:

• High school diploma or GED preferred

• Minimum two years related experience preferred, such as accounts receivable follow-up, insurance follow-up and appeals, insurance posting, professional medical/billing, medical payment posting, and/or cash application.

• Prior experience reading and interpreting Explanation of Benefits (EOB) required

• Coding certification through AHIMA or AAPC strongly preferred

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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.

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"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 Clinical Denials Coding Review Specialist 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. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.