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Prebill Denials Analyst in Nashville at Parallon

Date Posted: 11/15/2018

Job Snapshot

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Job Description

Prebill Denials Analyst
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.
Job Summary – The Prebill Denials Analyst will review post discharge, prebill accounts that do not have an authorization on file, ALOS versus days authorized variances, and/or other account discrepancies identified that will result in the account being denied by the payor that do not require a clinical review. Communicates with third party payors to resolve discrepancies prior to billing. Accurately and concisely documents all communications and action taken on the account in accordance with policies and procedures. The Prebill Denials Analyst will escalate medical review   request and/or denial activities to the Prebill Denials Nurse.

  • Work prebill accounts imported into the PDU Tool efficiently and effectively on a daily basis to resolve accounts with “no auth numbers and ALOS vs. authorized days variances
  • Work assigned accounts in eRequest to resolve outstanding issues
  • Report insurance denial trends identified during daily operational assignments
  • Identify problem accounts and escalate as appropriate
  • Document actions taken on the account clearly and concisely
  • Contacting the facilities, physicians’ offices and/or insurance companies to resolve denials/appeals
  • Adhere to time and attendance policies
  • Adhere to all policies and procedures, including phone and internet usage, break utilization, etc.
  • Participate in ongoing education and training as needed
  • Establish and maintain relationships with all customers

Job Requirements

High school diploma or GED required.
One year of related experience required. Experience in the following areas: appeals, denials, managed care, verifications/notification, precertification experienced preferred