Appeal Resolution Manager jobs in Gainesville, FL

Introduction

Are you looking for a work environment where diversity and inclusion thrive? Submit your application for our Claims Resolution Specialist opening with Parallon today and find out what it truly means to be a part of the HCA Healthcare team.

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.

We are seeking a Claims Resolution Specialist for our team to ensure that we continue to provide all patients with high quality, efficient care. Did you get into our industry for these reasons? We are an amazing team that works hard to support each other and are seeking a phenomenal addition like you who feels patient care is as meaningful as we do. We want you to apply!

Job Summary and Qualifications

Seeking a Claims Resolution Specialist who is responsible for applying fundamental knowledge of healthcare revenue cycle practices and procedures as it relates to researching, analyzing, and resolving open insurance claims and balances. This job requires regular outreach to payors. 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:

• Conduct follow-up with payors, vendors, and clearinghouse on open insurance claims and balances in compliance with departmental policies and procedures
• Resubmit primary and secondary claims
• Identify potential claim issues and escalate to management
• Review, identify, and resolve payor denials
• Update patient accounts as appropriate
• Ensure adjustments are posted timely and correctly for claims that need to be adjusted
• Resolve claims impacted by payor recoupments and refunds

What qualifications you will need:

• High school diploma or GED preferred
• Minimum of 1 year related healthcare experience preferred
• Relevant education may substitute experience requirement

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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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"Across HCA Healthcare’s more than 2,000 sites of care, our nurses and colleagues have a positive impact on patients, communities and healthcare.
Together, we uplift and elevate our purpose to give people a healthier tomorrow."- Jane Englebright, PhD, RN CENP, FAAN
Senior Vice President and Chief Nursing Executive

If you find this opportunity compelling, we encourage you to apply for our Claims Resolution Specialist opening. We promptly review all applications. Highly qualified candidates will be directly contacted by a member of our team. We are interviewing apply today!

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.