Prebill Denials Nurse in Norcross at Parallon

Date Posted: 8/5/2019

Job Snapshot

Job Description

*** This is a work from home position***


Parallon believes that organizations that continuously learn and improve will thrive. That’s why, after more than a decade, we remain 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.
 
We are looking for a dynamic candidate to be part of our team.  We offer excellent benefit packages, including 401K, bonus potential, tuition reimbursement, medical and dental plans, flexible spending plans, long-term/ short -term disability, and generous paid time off!
 
DUTIES INCLUDE BUT ARE NOT LIMITED TO:
  • Evaluates clinical documentation on multiple patient accounts and escalates issues through the established channels
  • Works post discharge, prebill accounts efficiently and effectively on a daily basis to resolve accounts with no auth numbers, ALOS vs. authorized days or other discrepancies
  • Works assigned accounts in eRequest to resolve outstanding issues
  • Report insurance denial trends identified during daily operational assignments
  • Assess CPT codes for out patient account that require authorization when accounts have not been coded
  • Contacts facilities, physician offices and/or insurance companies to resolve denials/appeals if needed

We are in need of an experienced Prebill Nurse. This position 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. We offer many opportunities for career growth. You need the following to be our top candidate:
  • Nursing degree
  • Current RN licensure with current state
  • Healthcare experience in an acute care hospital
  • Utilization review, appeals, denials, managed care contracting experience preferred


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