Manager Medical Insurance Appeals

This position is incentive eligible. Introduction This Work from Home position requires that you live and will perform the duties of the position within 60 miles of an HCA Healthcare Hospital (Our hospitals are located in the following states: FL, GA, ID, KS, KY, MO, NV, NH, NC, SC, TN, TX, UT, VA). Do you want to join an organization that invests in you as a Manager Appeals? 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. Benefits 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 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 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 Manager Appeals like you to be a part of our team. Job Summary and Qualifications The Appeals Manager is responsible for managing all activities related to monitoring and appealing denials received from Third Party Payers. In this role you will: • Manage daily activities and inventory related to SSC Appeals function, ensuring processes are performed accurately, efficiently and effectively within all established operational and SOX guidelines. • Analyze trends in insurance denials and work with insurance companies to resolve underlying reasons for denials • Manage recurring coding or clinical documentation issues and correct the underlying causes for errors. • Coordinate with all necessary departments related to contract issues. • Perform QA for all processes within Appeals • Screen, interview, and hire new employees • Arrange for training of new employees • Review each staff member’s productivity on a monthly basis and performing annual evaluations • Counsel staff with disciplinary and productivity issues • Work as a liaison between the Appeals staff and other SSC staff • Resolve issues escalated by Appeals staff • Conduct monthly staff meetings Qualifications that you will need: • Bachelor’s Degree in Business or related field required. • Minimum one to three years’ experience in related area (with two of these years being healthcare management experience) or current participant in the Parallon Manager Trainee Program. • Experience with Insurance Follow up 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 Manager Appeals 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. Apply tot his job Apply To this Job