Description
Introduction
Do you want to join an organization that invests in you as a Workers Compensation Claims Resolution Specialist? 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.
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 (https://careers.hcahealthcare.com/pages/employee-benefits-and-rewards)
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 Workers Compensation Claims Resolution Specialist like you to be a part of our team.
Job Summary and Qualifications
The Revenue Cycle Representative will process claim files for payment from Health plans and/or Third Party Payors: Workmen's Compensation, Automobile, Property and Casualty, and Health Insurers. Contacts Health plans and/or Third-Party Payors. Attorneys to maximize client reimbursements for services and recover all monies properly owed to our clients.
In this role you will:
Identify viable payer(s) and obtain all necessary documentation to properly process the claim for payment including, when applicable, IBs, UBs, Medical Records, POs, EOBs when necessary.
Coordinate benefits with all available payers to appropriately maximize the client's recovery while minimizing the patient's personal responsibility.
Review and process for payment all claims, in which adequate billing information has been obtained, to the appropriate insurance carrier within 24 hours of receipt of said information.
Correspond with patients, employers, policyholders, insurers, police, witnesses or other parties involved in the accident, and attorneys to obtain additional, relevant information to support the claim for monies owed.
Review status of litigated claims (if applicable) and confer with attorneys and third party carriers regarding case disposition.
Converse with the insurer(s) and appeal when appropriate to guarantee that all available benefits are recovered and that claims are reimbursed at the appropriate/maximum level(s).
Use the operating systems (FACS, SSI or successor systems, etc.) to perform timely processing and follow up on every claim from initial placement thru resolution.
Professionally respond to customer inquiries and requests that may require extracting, synthesizing, and analyzing system data.
Prepare appeals, account summaries, offers of compromise, pro ration of funds, and compile other relevant data.
Remain current with all local, state and federal statutes and act within the limits of the law.
Understand all specific billing requirements for each applicable state and payer for which you are responsible.
Establish and maintain constructive working relationships with insurance carriers, clients, external business contacts and staff.
All Claims Representatives must maintain the highest level of confidentiality and comply with all HIPAA regulations and Business Associate Agreements with its clients.
Practices and adheres to the "Code of Conduct" philosophy and "Mission and Values Statement"
Attend Privacy and Security Training as required by the HIPAA Awareness Program and comply with all guidelines, policies and procedures to assure sensitive or confidential information is protected in accordance with the HIPAA rules and regulations.
Qualifications that you will need:
High School Diploma or GED required
2 years of directly related industry experience
Relevant education may substitute experience requirement.
Must have experience in reading and understanding UB04 and HCFA forms.
Experience in Workman's Compensation and Motor Vehicle Claims processing
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.
"Good people beget good people."- Dr. Thomas Frist, Sr.
HCA Healthcare Co-Founder
We are a family 270,000 dedicated professionals! Our Talent Acquisition team is reviewing applications for our Workers Compensation Claims Resolution Specialist opening. Qualified candidates will be contacted for interviews.Submit your resume today to join our community of caring!
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.
