Clinical Denials Coding Review Specialist Position Available In Davidson, Tennessee

Clinical Denials Coding Review Specialist
Work from Home
Nashville, TN, United States
schedule Full-time • Work From Home

HIMS and Health Informatics Job ID:

3299621
Description
Introduction
Do you have the career opportunities as a Clinical Denials Coding Review Specialist you want with your current employer? We have an exciting opportunity for you to join Parallon which is part of the nation’s leading provider of healthcare services, HCA Healthcare.
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.
Our teams are a committed, caring group of colleagues. Do you want to work as a Clinical Denials Coding Review Specialist where your passion for creating positive patient interactions is valued? If you are dedicated to caring for the well-being of others, this could be your next opportunity. We want your knowledge and expertise!
Job Summary and Qualifications
Seeking a Clinical Denials Coding Review Specialist, who is responsible for ing 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 ! 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 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.
“Bricks and mortar do not make a hospital. People do.”- 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 for our Clinical Denials Coding Review Specialist opening. We promptly review all applications. Highly qualified candidates will be contacted for interviews. Unlock the possibilities and !
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.