Appeals Team Lead - Days in Largo, FL at Parallon

Date Posted: 7/19/2018

Job Snapshot

  • Employee Type:
    Full-Time
  • Location:
    Largo, FL
  • Job Type:
  • Experience:
    At least 1 year(s)
  • Date Posted:
    7/19/2018

Job Description

The Company: Parallon Business Solutions is a subsidiary of Hospital Corporation of America and HCA West Florida. We provide a variety of services including revenue cycle, supply chain management, and workforce management to 1,400 hospitals and 11,000 non-acute care providers, including ambulatory surgery centers, physician practices and alternate care sites. We have been voted one of the top employers in Florida for 8 years in a row, and are known for taking the best care of clients and employees alike.
● Our culture fosters an environment of continuous growth and professional development.
● Parallon was named a “Top 100 Company to Watch for Remote Jobs in 2016” by FlexJobs.
● We believe in rewarding our employees with a healthy work/life experience, our employees are rewarded with comprehensive health and wellness benefits, financial and retirement planning support, and time away from work options.


Job Summary – The Appeals Team Lead is responsible for performing daily appeals follow-up, monitoring denial trends/issues and assisting the Appeals Manager with training of the appeals department.
Supervisor –Appeals Manager
Supervises – N/A
Duties (included but not limited to):
• Provides introductory and ongoing training and education to all Appeals staff to ensure that policies and procedures are followed
• Meets with the Manager regularly to effectively communicate and resolve issues, set and prioritize goals and improve processes
• Assists with staff communication, providing updates, resolving issues, setting goals and maintaining standards, including performing QA reviews for staff
• Maintains established departmental policies and procedures, objectives, patient and customer service policies
• Assists with payroll activities for team members (i.e. edit sheets)
• Assists manager with development and implementation of project and department action plans
• Monitors insurance denials by running appropriate reports and contacting insurance companies to resolve claims denied for clinical reasons
• Identifies coding or clinical documentation issues and work to correct the errors in a timely manner
• Identifies problem accounts and/or trended issues and escalates as appropriate
• Updates the patient account record to identify actions taken on the account
• Practice and adhere to the “Code of Conduct” philosophy and “Mission and Value Statement”
• Performs other duties as assigned

Job Requirements

KNOWLEDGE, SKILLS & ABILITIES
• Organization - proactively prioritizes needs and effectively manages resources
• 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, 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
• Leadership - guides individuals and groups toward desired outcome by providing training, advice and feedback to assist/support employees in achieving established performance standards
• Tactical execution - assist in monitoring operational processes and making recommendations for changes/adjustments as needed during the implementation or change to new products or processes
• 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.
• Clinical skills - ability to read and interpret medical records
EDUCATION
High School diploma or GED required.
EXPERIENCE
• At least one year of related experience required.
CERTIFICATE/LICENSE – N/A
PHYSICAL DEMANDS/WORKING CONDITIONS
Requires prolonged sitting/standing, some bending, stooping, walking and stretching. Requires eye-hand coordination and manual dexterity sufficient to operate a keyboard, photocopier, telephone, calculator and other office equipment. Requires normal range of hearing and eyesight to record, prepare and communicate appropriate reports or other information. Requires lifting papers/boxes and pushing/pulling up to 25 pounds occasionally. Work is performed in an office environment or hospital setting. Work may be stressful at times. Contact may involve dealing with angry or upset people. Staff must remain flexible and available to provide staffing assistance for any/all disaster or emergency situations.

 

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