Clinical Appeals Director in Irving, TX at Parallon

Date Posted: 3/16/2018

Job Snapshot

  • Employee Type:
  • Location:
    10030 North MacArthur Boulevard
    Irving, TX
  • Job Type:
  • Experience:
    Not Specified
  • Date Posted:

Job Description

Have an impact on patient experience and employee satisfaction as well as the success of the hospital and Shared Services Center! Come to work for Parallon, an organization of prominence and sterling reputation which can position the best and brightest for continued growth, development and promotion!


Parallon's Mission: 
We serve and enable those who care for and improve human life in their communities. 


Parallon is a division of HCA, the largest for profit healthcare organization in the world. We are dedicated to our values and passionate about finding future leaders for our fast-growing organization. Despite our size and breadth, we maintain the people-first culture that was Dr. Thomas Frist’s original vision for the company 50 years ago.


The Appeals Director is responsible for daily operations of all functions and oversight of all activities related to monitoring and appealing denials received from Third Party Payers. 


Duties include, but are not limited to: 

  • Oversee the activities and management related to denial inventory, ensuring processes are performed efficiently, effectively and accurately within all established operational and SOX guidelines.
  • Establish controls and review mechanisms for policies and procedures.
  • Ensure timely submission of appeals and liquidation of denials inventory.
  • Provide support and guidance related to the Denials Management Action Teams (DMAT)
  • Monitor, trend and communicate with Senior Leadership, Case Management, Denials Managers, and Facility Leadership regarding denial trends, new denials and final write off denials identified via EDW, Visual Insight Dashboard, Vista, and other denials tools reports.
  • Understand and communicate contract specific issues related to the resolution of disputed payments, discount and allowance calculations for a variety of payers such as Medicare, Medicaid, HMOs, PPOs, IPAs, employers, etc.









Job Requirements


  • Bachelor’s Degree in Business or related field required. If a desired applicant does not have a Bachelor's Degree the requirement can be waived IF they are currently in a Bachelor Degree program.


  • Minimum 5 years healthcare management experience with three of these years in the related area for the position. Relevant experience may substitute experience requirement provided candidate is currently enrolled in a degree program. 

At Parallon, every employee is a valued member of our organization. You can expect to receive competitive salary, ongoing professional development, comprehensive benefits package, performance bonuses and more!


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