Prebill Analyst Work From Home

Prebill Analyst Work From Home

(Job Number: 26514-152799)

Work Location: United States-Texas-San Antonio-Prebill Denial – San Antonio

Schedule: Full-time

Job Type: Finance Acctg Billing Claims & Revenue 

Description:

Parallon is one of the country’s largest premier revenue cycle partners, with more than 15,800 employees serving 600+ hospitals and 3,000+ physician practices. Annually, we collect more than $41 billion and interact with 37 million patients. Our track record of results is among the best in the industry. We serve hospitals, physician practices and healthcare systems by bringing deep operational knowledge and tailored revenue cycle solutions so that providers can focus on fulfilling their mission.

Prebill Denials Analyst:

Job Summary – The Prebill Denials Analyst will review post discharge, prebill accounts that do not have an authorization on file, ALOS versus days authorized variances, and/or other account discrepancies identified that will result in the account being denied by the payor that do not require a clinical review. Communicates with third party payors to resolve discrepancies prior to billing. Accurately and concisely documents all communications and action taken on the account in accordance with policies and procedures. The Prebill Denials Analyst will escalate medical review request and/or denial activities to the Prebill Denials Nurse.

Supervisor – Prebill Denials Director/Manager

Supervises – Not Applicable

Duties (included but not limited to):

1. Work prebill accounts imported into the PDU Tool efficiently and effectively on a daily basis to resolve accounts with “no auth numbers and ALOS vs. authorized days variances
2. Work assigned accounts in eRequest to resolve outstanding issues
3. Report insurance denial trends identified during daily operational assignments
4. Identify problem accounts and escalate as appropriate
5. Document actions taken on the account clearly and concisely
6. Contacting the facilities, physicians’ offices and/or insurance companies to resolve denials/appeals
7. Adhere to time and attendance policies
8. Adhere to all policies and procedures, including phone and internet usage, break utilization, etc.
9. Participate in ongoing education and training as needed
10. Establish and maintain relationships with all customers
11. Seeks assistance from immediate supervisor when in situations which are unclear or ambiguous
12. Adheres to established policy and procedure and escalates issues through the established Chain of Command
13. Demonstrates commitment to teamwork and cooperation
14. Practice and adhere to the “Code of Conduct” philosophy and “Mission and Value Statement”
15. Other duties as assigned

Qualifications:

KNOWLEDGE, SKILLS & ABILITIES

• Communication - communicates clearly and concisely, verbally and in writing. This includes utilizing proper punctuation, correct spelling and the ability to transcribe accurately.
• Customer orientation - establishes and maintains long-term customer relationships,
• Interpersonal skills - able to work effectively with other employees, patients and external parties
• PC skills - demonstrates proficiency in Microsoft Office applications and others as required
• Policies & Procedures - demonstrates knowledge and understanding of organizational policies, procedures and systems
• Basic skills - demonstrates ability to organize, perform and track multiple tasks accurately in short timeframes, have ability to work quickly and accurately in a fast-paced environment while managing multiple demands, ability to work both independently and collaboratively as a team player, adaptability, analytical and problem solving ability and attention to detail and able to perform basic mathematical calculations, balance and reconcile figures, punctuate properly, spell correctly and transcribe accurately.

EDUCATION:

• High school diploma or GED required.
• EXPERIENCE
• One year of related experience required. Experience in the following areas: appeals, denials, managed care, verification/notification, pre-certification experienced preferred

Parallon/HCA is an equal opportunity workforce and no one shall discriminate against any individual with regard to race, color, religion, sex, national origin, age, disability, sexual orientation, gender identity or expression, genetic information or veteran status with respect to any offer, or term or condition, of employment. We make reasonable accommodations to the known physical and mental limitations of qualified individuals with disabilities.

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