Payment Resolution Director

Payment Resolution Director

Come join our team as a Payment Resolution Director. We care for our community! Just last year, HCA Healthcare and our colleagues donated $13.8 million dollars to charitable organizations. Apply Today!

As the Payment Resolution Director, you will be responsible for overseeing the remittance advice discrepancy function, which includes the collection of disputed underpayments and the processing of refunds of overpayments. You will be responsible for the consistent application of all standard A / R and Accounting processes, and for accurate and timely discount and allowance calculations, analyses and reconciliations of accounts receivable related to discrepancy payments and denials. As part of this role, you must demonstrate a strong commitment to stakeholder relationships by taking ownership of issues and facilitating effective outcomes in a timely manner.

What you will do in this role :

• Oversee the activities and management related to Payment Compliance discrepancy inventory, ensuring processes are performed efficiently, effectively, and accurately.
• Establish controls and review mechanisms for SSC policies and procedures.
• Ensure timely submission of reconsiderations, payer packages and liquidation of discrepancy inventory.
• Monitor, trend and communicate with SSC, facility and corporate leadership, regarding trends, new inventory fluctuations and outstanding inventory identified via EDW, Vista, Visual Insights and other denials tools reports.
• Understand and communicate contract specific issues related to the resolution of disputed payments, discount and allowance calculations for a variety of payers such as Medicare, Medicaid, HMOs, PPOs, IPAs, employers, etc.
• Follow escalation protocols to include Attorney, Corporate Dispute Resolution, Strategic Pricing and Analytics and Corporate Payment Compliance.

What qualifications you will need :

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.

The great hospitals will always put the patient and the patient's family first, and the really great institutions will provide care with warmth, compassion, and dignity for the individual."- Dr. Thomas Frist, Sr. HCA Healthcare Co-Founder

If you are looking for an opportunity that provides satisfaction and personal growth, we encourage you to apply for our Payment Resolution Director opening. We promptly review all applications. Highly qualified candidates will be contacted for interviews. 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.