Hospital Bill Audit Coordinator - WFH - Full-time in Richmond, VA at Parallon

Date Posted: 2/28/2018

Job Snapshot

Job Description

Parallon is an affiliate of Hospital Corporation of America (HCA Holdings, Inc.) and is a leading provider of healthcare business and operational services. Parallon supports healthcare providers in the area of revenue cycle (billing, collections, denial management), technology, patient registration, insurance verification and health information management.


Job Summary - Assist in managing and analyzing hospital bill audits by third party payers. Position will serve as liaison between payors, hospitals, and the Shared Service Center (SSC) regarding status of pending, ongoing and finalized audits. Position will evaluate the requests received by the payors to assess if the request is within the terms established by contracts and in accordance with the Hospital Bill Audit by Third Party Payers Policy. Position will notify appropriate responsible parties of reviews and maintain documentation of audit requests, current status, and outcomes of audits in a centralized location. Position will track and trend types of audits received and report findings to Manager.


Duties (included but not limited to):
• Interacts and coordinates handoffs of audits between responsible SSC departments such as Revenue Integrity for insurance charge audit reviews, HSC for coding or DRG related reviews and Ethics and Compliance and HCA – Regulatory Compliance Support (Regs) for government audits. Position will communicate with payor representatives related to audit request and coordination of audits to be performed.
• Analyze and approve audit requests received from payors
• Interact with payor to resolve questions or concerns related to coordination of audit request
• Maintain tracking of audits and coordinate obtaining the medical record for auditor to perform on-site audits
• Communicate approved and denied insurance defense audits
• Maintain statistical data as required
• Practice and adhere to the "Code of Conduct" philosophy and "Mission and Value Statement"
• Other duties as assigned


Job Requirements

• Associate degree preferred; Equivalent work experience may substitute.
• Three years of hospital business office or related financial experience preferred.
• Project management and payor contract experience preferred.


We offer free parking, training support, competitive salary and excellent benefits to include several insurance package options for Medical, Dental and Vision; Paid Time Off for vacation, sick leave and holidays, Employer-paid Short Term Disability, Company matching 401K and more!

Parallon is an Equal Opportunity Employer (EOE), minority/ female/ veteran/ disabled, offering a great work environment, challenging career opportunities, and competitive compensation.