Overpayment Resolution Manager Payer Specialization Unit in Nashville, TN at Parallon

Date Posted: 2/22/2018

Job Snapshot

  • Employee Type:
  • Location:
    1100 Charlotte Avenue
    Nashville, TN
  • Job Type:
  • Experience:
    At least 3 year(s)
  • Date Posted:

Job Description

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 revenue cycle services. 

The Overpayment Resolution Manager is responsible for managing all activities related to analyses and resolution of overpayment discrepancies, credit balances and the refund process. 

Duties (included but not limited to): 
• Manage daily activities related to SSC overpayment discrepancy, refund and credit balance resolution functions, ensuring processes are performed effectively and efficiently. 
• Analyze trends in discrepancy coding and work to decrease incoming inventory 
• Assure that verified overpayment discrepancies are refunded timely and accurately. 
• Identify internal and external opportunities (contract language, processes) to facilitate effective operations. 
• Work as a liaison between the overpayment resolution staff and other SSC staff 
• Resolve issues escalated by staff 
• Conduct monthly staff meetings 
• Review each staff member’s productivity on a monthly basis and performing annual evaluations 
• Screen, interview and hire new employees. 
• Arrange training of new employees. 
• Review each staff member’s productivity on a monthly basis and performs annual evaluation. 
• Counsel staff with disciplinary and productivity issues. 
• Resolve issues escalated by overpayment resolutions staff. 
• Practice and adhere to the “Code of Conduct” philosophy and “Mission and Value Statement” 
• Other duties as assigned


Job Requirements

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 

• 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. The ability to communicate with staff, Parallon Management, Division and Group Executives 
• 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 outcomes, setting high performance standards and delivering leading quality services 
• Tactical execution - oversees the development, deployment and direction of complex programs and processes 
• Project Management - assesses work activities and allocates resources appropriately 
• 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 time frames, 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. 

• Bachelor’s Degree in Business or related field required. Equivalent work experience may substitute education requirements. 

• Minimum three years’ experience in related area with two of these years being healthcare management experience OR completion of the Parallon Manager Trainee Program. 

• N/A