Clinical Appeals Specialist LPN/RN

This job is no longer active. View similar jobs.

POST DATE 9/13/2016
END DATE 11/16/2016

HCA Healthcare Cottonwood Heights, UT

Company
HCA Healthcare
Job Classification
Full Time
Company Ref #
08942-122972
AJE Ref #
576162584
Location
Cottonwood Heights, UT
Experience
Entry Level (0 - 2 years)
Job Type
Regular
Education
Associates Degree

JOB DESCRIPTION

APPLY
Job Code: 08942-122972

Full-time

No Weekends

Parallon believes that organizations that continuously learn and improve will thrive. That's why, after more than a decade, Parallon remains dedicated to helping hospitals and hospital systems operate knowledgeably, intelligently, effectively and efficiently in the rapidly evolving healthcare marketplace, today and in the future.
As one of the healthcare industry's leading providers of business and operational services, Parallon is uniquely equipped to provide a broad spectrum of customized services in the areas of revenue cycle, purchasing, supply chain, technology, workforce management and consulting.
Parallon's purpose is simple. We serve and enable those who care for and improve human life in their communities.





KEY RESPONSIBILITIES

-Monitor insurance denials by running appropriate reports and contacting insurance companies to resolve claims denied for clinical reasons

-Identify coding or clinical documentation issues and work to correct the errors in a timely manner

-Identify problem accounts and escalates as appropriate

-Update the patient account record to identify actions taken on the account

-Work with guarantors to secure payment on account balances outstanding for clinical reasons

-Practice and adhere to the "Code of Conduct" philosophy and "Mission and Value Statement"

-Other duties as assigned

COMMUNICATION-communicates clearly and concisely, verbally and in writing

CUSTOMER ORIENTATION - establishes and maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations

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 -able to perform basic mathematical calculations, balance and reconcile figures, punctuate properly, spell correctly and transcribe accurately

CLINICAL SKILLS

ability to read and interpret medical records





EDUCATION

Associate s Degree preferred



EXPERIENCE

At least one year case management experience required



Relevant education may substitute experience requirement

CERTIFICATE/LICENSE



Last Edited: 08/01/2016