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Appeals Specialist - Richmond Shared Services Center

Appeals Specialist - Work from Home - Richmond Shared Services Center
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Parallon is an affiliate of Hospital Corporation of America (HCA Holdings, Inc.) and is a leading provider of healthcare business and operational services.? Parallon supports healthcare providers in the areas of revenue cycle (billing, collections, and denial management), technology, patient registration, insurance verification, and health information management.
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WORK FROM HOME ? REQUIREMENTS ?
MUST RESIDE IN THE GREATER RICHMOND AREA

  • ON-SITE Training REQUIRED in Richmond, VA?(approximately 120 days or more)

  • Internet Connectivity requirements - At a minimum:?

  • Cable or DSL(Digital Subscriber Line)

  • Minimum Download Speed:? 1 MB/S

  • Minimum Upload Speed:? 512 KB/S

  • Minimum Latency:? under 90ms?

  • Please contact your internet service provider for verification of the specifications listed above.?



The Appeals Specialist?is responsible for performing end to end tasks for the technical appeals process. This is a Full Time opportunity, working Monday through Friday, from 8:30AM to 5:00PM, including weekends and holidays to assist with the fiscal month end close.
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Duties (include but not limited to):
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  • Triage incoming inventory for the Appeals team, validating appeal criteria is met

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

  • Identify contract protection that can be leveraged to overturn denials.

  • 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.

  • Ability to perform basic math calculations, to ensure accurate statement of accounts receivable

  • Ability to punctuate properly, spell correctly and transcribe accurately



EDUCATION

  • High school diploma or GED



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EXPERIENCE

  • Minimum of one year related work experience required

  • Strong Microsoft Excel experience required

  • The ability to read and interpret medical records preferred



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We offer a convenient location, free parking, training support, competitive compensation, and excellent benefits that include several insurance packages to choose from, paid time off for vacation, sick leave and holidays, company matching 401K.
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Parallon is an Equal Opportunity Employer (EOE), minority/Female/Veteran/Disabled, offering a great work environment, challenging career opportunities, and competitive compensation.


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