Virtual Appeals Manager in Nashville, Tennessee, United States
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Virtual Appeals Manager

Work from Home
Nashville, TN, United States
Full-time • Work From Home
Directors and Managers   Job ID: 554786
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Description

Introduction

Are you looking for a work environment where diversity and inclusion thrive? Submit your application for our Virtual Appeals Manager opening with Parallon today and find out what it truly means to be a part of the HCA Healthcare team.

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 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.

We are seeking a Virtual Appeals Manager for our team to ensure that we continue to provide all patients with high-quality, efficient care. Did you get into our industry for these reasons? We are an amazing team that works hard to support each other and are seeking a phenomenal addition like you who feels patient care is as meaningful as we do. We want you to apply!

Job Summary and Qualifications

As the Appeals Manager, you will be responsible for managing all activities related to monitoring and appealing denials received from Third Party Payers.

What you will do in this role:

  • 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

Qualified candidates will possess:

  • Bachelor’s Degree in Business or related field required. Equivalent work experience may substitute education requirements.
  • Minimum three years’ experience in related area with two of these years being healthcare management experience OR completion of the Parallon Manager Trainee Program.

"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."

"Across HCA Healthcare’s more than 2,000 sites of care, our nurses and colleagues have a positive impact on patients, communities and healthcare.
Together, we uplift and elevate our purpose to give people a healthier tomorrow."- Jane Englebright, PhD, RN CENP, FAAN
Senior Vice President and Chief Nursing Executive

If you find this opportunity compelling, we encourage you to apply for our Virtual Appeals Manager opening. We promptly review all applications. Highly qualified candidates will be directly contacted by a member of our team. We are interviewing; 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.

This position is incentive eligible.

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Details

Directors and Managers
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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