Hospital Bill Audit Coordinator in Largo at Parallon

Date Posted: 11/7/2018

Job Snapshot

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.
● HCA has been a Military Friends Spouse Employer for 8 years in a row.
● 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 - 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.
Supervisor – Revenue Integrity Director/Revenue Integrity Manager
Supervises – N/A
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

KNOWLEDGE, SKILLS & ABILITIES
• 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
• 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.
• Technical Knowledge - Knowledge of payer contract requirements preferred but not required
EDUCATION
• Associate degree preferred; Equivalent work experience may substitute.
EXPERIENCE
• Three years of hospital business office or related financial experience preferred.
• Project management and payor contract experience preferred.
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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MOC: 3043, 001672