Manager Medical Insurance Appeals

Overview

This position is incentive eligible.

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, , KS, KY, MO, NV, NH, NC, SC, TN, TX, UT, VA).

Do you want to join an organization that invests in you as a Manager Appeals? 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.

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 Air Med 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.

You contribute to our success. Every role has an impact on our patients’ lives and you have the opportunity to make a difference. We are looking for a dedicated Manager Appeals like you to be a part of our team.

The Appeals Manager is responsible for managing all activities related to monitoring and appealing denials received from Third Party Payers.

• Manage daily activities and inventory related to SSC Appeals function, ensuring processes are performed accurately, efficiently and effectively within all established operational and SOX guidelines.
• Analyze trends in insurance denials and work with insurance companies to resolve underlying reasons for denials
• Manage recurring coding or clinical documentation issues and correct the underlying causes for errors.
• Coordinate with all necessary departments related to contract issues.
• Perform QA for all processes within Appeals
• Screen, interview, and hire new employees
• Arrange for training of new employees
• Review each staff member’s productivity on a monthly basis and performing annual evaluations
• Counsel staff with disciplinary and productivity issues
• Work as a liaison between the Appeals staff and other SSC staff
• Resolve issues escalated by Appeals staff
• Conduct monthly staff meetings

• Bachelor’s Degree in Business or related field required.
• Minimum one to three years’ experience in related area (with two of these years being healthcare management experience) or current participant in the Parallon Manager Trainee Program.
• Experience with Insurance Follow up

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…