Senior Appeals Analyst

HCA Healthcare • Nashville, TN

96d • Remote

About The Position

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 Senior Appeals Analyst? 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.

Requirements

• Bachelor's degree in business or related field required. Relevant work experience may substitute degree requirements.
• Two years of related experience preferred.
• Ability to perform advanced mathematical calculations and balance and reconcile figures.

Responsibilities

• Review technical and clinical denial arguments for reconsideration on top dollar accounts, including both written and telephonically through resolution process.
• Identify coding or clinical documentation issues and work to correct the errors in a timely manner.
• 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 accounts.
• Identify and communicate contract interpretation issues and language discrepancies to leadership as appropriate.
• Identify Payer company trends and communicate trends to supervisor for further action/escalation.
• Serve as a subject matter expert in payer appeals resolution process.

Benefits

• 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.

What This Job Offers

• Career Level: Mid Level
• Industry: Hospitals
• Education Level: Bachelor's degree