Appeals Analyst in Nashville, Tennessee, United States
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Appeals Analyst

Work from Home
Nashville, TN, United States
Full-time • Work From Home
Finance Accounting Billing Claims and Revenue   Job ID: 447792
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Are you passionate about the patient experience? At HCA Healthcare, we are committed to caring for patients with purpose and integrity. We care like family! Jump-start your career as a(an) Appeals Analyst today with Work from Home.


Work from Home, 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 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.
  • Fertility and family building benefits through Progyny
  • Free counseling services and resources for emotional, physical and financial wellbeing
  • Family support, including adoption assistance, child and elder care resources and consumer discounts
  • 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)
  • Employee Stock Purchase Plan
  • Retirement readiness and rollover 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)

Learn more about Employee Benefits

Note: Eligibility for benefits may vary by location.

Come join our team as a(an) Appeals Analyst. We care for our community! Just last year, HCA Healthcare and our colleagues donated $13.8 million dollars to charitable organizations. Apply Today!

Job Summary and Qualifications

The Clinical Appeals Analyst is responsible to support the Attorney serving in the role of Senior Counsel, Aetna Appeals. This individual will be responsible to confirm claim denials/appeals, place claims into new and existing categories, and follow pre-established escalation and resolution protocols. This position will be critical in supporting the Payer specialization strategy focused on denial cash conversion and ultimately avoidance. Processing large claim volumes efficiently and effectively, with technology, while providing the highest levels of customer service and attention to details is required. Success in this position will be indicated by a high volume of throughput, escalation, and successful underpayment resolution.

What you will do in this role:

Perform and validate claim level denial and appeal inventory

Prepare documentation to support additional payment from payers

Communicate clearly, such as telephonically, online or via payment package processes to both internal and external parties

Overcome objections that prevent payment of the claim

Gain commitment, when required, for payment through concise and factual collection techniques

Communicate trends to management as identified

Facilitatecorrectionofnon-paymentrelateddiscrepanciesthroughI-planchangesorcoordinationwithotherdepartmentsas needed

Identify and communicate trends to management, including those that might be appropriate for the dispute resolution process

Escalate accounts to appropriate individuals at the payer and management as needed, including accounts with lack of timely payer response

Utilize effective documentation standards that support a strong historical record of actions taken on the account.

What qualifications you will need:

Bachelor’s Degree required.

Three years of related experience required.

HealthTrust Supply Chain is a critical part of HCA Healthcare’s strategy. Our focus is to improve performance and reduce costs. We do this by joining non-clinical and administrative functions. HealthTrust Supply Chain best practice methodologies. We develop, apply and monitor cost-efficient initiatives and programs for HCA Healthcare. By improving facility efficiency, medical professionals can focus on our mission - patient care.

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.

"The great hospitals will always put the patient and the patient's family first, and the really great institutions will provide care with warmth, compassion, and dignity for the individual."- 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 Appeals Analyst 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 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.


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Work from Home
Full-time • Work From Home

COVID-19 Vaccination

In compliance with the emergency regulation issued by the Centers for Medicare & Medicaid Services (CMS) dated November 4, 2021, and company policy, this role MAY require you to be fully vaccinated for COVID-19 based on local, state and /or federal law or regulations, or to have applied for a medical or religious exemption (including booster for California). (For further clarification, please ask your recruiter.)

About HCA Healthcare

What matters most to our diverse and talented colleagues is giving people the absolute best healthcare in the most compassionate way possible.

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