Claims Resolution Specialist

Introduction

Work from Home position that requires you to live within 60 miles of an HCA Healthcare Hospital in one of the following states: FL, GA, , KS, KY, MO, NV, NH, NC, SC, TN, TX, UT, VA.

• Comprehensive medical coverage with low or no copay; includes prescription drug, behavioral health, telemedicine, and Air Med transportation.
• Dental & vision, life & disability coverage, flexible spending accounts, supplemental health plans (accident, critical illness, hospital indemnity), auto & home insurance, identity‑theft protection, legal counseling, long‑term care, moving assistance, pet insurance, and more.
• Free counseling services and resources for emotional, physical and financial wellbeing.
• 401(k) with 100% match on 3–9% of pay (based on years of service).
• Employee Stock Purchase Plan with 10% off HCA Healthcare stock.
• Family support — fertility and family building benefits through 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 other programs.
• Retirement readiness, rollover assistance 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, leaves of absence.
• Employee Health Assistance Fund offering free coverage to part‑time and full‑time colleagues based on income.

Note:

Eligibility for benefits may vary by location.

The Claims Resolution Specialist applies fundamental knowledge of healthcare revenue cycle practices to research, analyze, and resolve open insurance claims and balances. The role involves regular outreach to payors.

• Conduct follow‑up with payors, vendors and clearinghouses on open insurance claims and balances in compliance with departmental policies and procedures.
• Resubmit primary and secondary claims.
• Identify potential claim issues and expedite 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.

• Minimum of 1 year related healthcare experience preferred.
• Relevant education may substitute the experience requirement.

Parallon provides full‑service revenue cycle management and total patient account resolution for HCA Healthcare. Services include scheduling, registration, insurance verification, hospital billing, revenue integrity, collections, payment compliance, credentialing, health information management, customer service, payroll and physician billing. Parallon also offers targeted solutions such as Medicaid Eligibility for external clients across the country. With over 17,000 colleagues, Parallon serves nearly 1,000 hospitals and 3,000 physician practices, impacting 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 on 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 apply for our Claims Resolution Specialist opening. We promptly review all applications. Highly qualified candidates will be contacted for interviews. Unlock the possibilities and apply today!

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.