Claims Resolution Specialist

Claims Resolution Specialist

Do you want to join an organization that invests in you as a Claims Resolution Specialist? At Parallon, you come first. HCA Healthcare has committed up to $300 million in programs to support our incredible team members over the course of three years. 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, additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans, auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance, free counseling services, 401(k) plan with a 100% match, employee stock purchase plan, family support, consumer discounts, retirement readiness, rollover assistance services, preferred banking partnerships, education assistance, colleague recognition program, time away from work program, and employee health assistance fund. Note : Eligibility for benefits may vary by location. You contribute to our success. Every role has an impact on our patients' lives and you have the opportunity to make a difference. We are looking for a dedicated Claims Resolution Specialist like you to be a part of our team.

Job Summary and Qualifications

The Claims Resolution Specialist is responsible for applying fundamental knowledge of healthcare revenue cycle practices and procedures as it relates to researching, analyzing, and resolving open insurance claims and balances. This job requires regular outreach to payors. In this role you will : conduct follow-up with payors, vendors, and clearinghouse on open insurance claims and balances in compliance with departmental policies and procedures, resubmit primary and secondary claims, identify potential claim issues and escalate to management, review, identify, and resolve payor denials, update patient accounts as appropriate, ensure adjustments are posted timely and correctly for claims that need to be adjusted, resolve claims impacted by payor recoupments and refunds, meet and maintain established departmental performance metrics for production and quality, and maintain working knowledge of workflow, systems, and tools used in the department. Qualifications : minimum one-year related healthcare experience preferred, relevant education may substitute experience requirement, previous call center experience is preferred, virtual employees are required to have high speed wired internet speed 25 MBS download and 6 MBS upload.

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.

Good people beget good people.- Dr. Thomas Frist, Sr. HCA Healthcare Co-Founder We are a family 270,000 dedicated professionals! Our Talent Acquisition team is reviewing applications for our Claims Resolution Specialist opening. Qualified candidates will be contacted for interviews. Submit your resume today to join our community of caring! 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.