Job Information
HCA Healthcare Denial Coding Review Specialist in Brentwood, Tennessee
Description
Introduction
Do you want to join an organization that invests in you as a Clinical Denials Coding Review Specialist? At Work from Home, 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
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.
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 Clinical Denials Coding Review Specialist like you to be a part of our team.
Job Summary and Qualifications
Seeking a Clinical Denials Coding Review Specialist, who 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. We are an amazing team that works hard to support each other and are seeking a phenomenal addition like you. We want you to apply today!
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
What qualifications you will need:
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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"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 Clinical Denials Coding Review 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 and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.