Senior Underpayment Analyst in San Antonio at Parallon

Date Posted: 6/25/2019

Job Snapshot

  • Employee Type:
    Full-Time
  • Location:
    San Antonio
  • Job Type:
  • Experience:
    Not Specified
  • Date Posted:
    6/25/2019

Job Description

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. 
 
 
Work From Home/Remote  
 
Senior Underpayment Analyst



Job Summary - Researches and Resolves High Dollar Insurance Payer Underpayments through concise understanding of Payer Contract language and respective payment calculation. Position requires individuals with high mathematical acumen, ability to access and assimilate data, articulate a strong case, confidence, and strong persuasion skill set. Results oriented individual will be required to work through various options available to liquidate the most difficult high dollar underpayments. Candidate will demonstrate ability to grow strategic payer relationships and obtain understanding of payer system to navigate through claims processing centers. Critical thinking skills are necessary, as well as ability to see trends that require escalation to the Payment Compliance Director. Responsible for bundling similar cases not resolved through the standard Payment Compliance process and escalate to Dispute Resolution Team for legal action.



Supervisor – Director, Payment Compliance
 
Supervises - N/A
 
Duties (included but not limited to):
 
• Analyzes hospital claims to identify contractual underpayments or billing errors.
• Resolves underpaid claims from various payer products including HMO, PPO, Medicaid, Medicare and Workers' Compensation.
• Articulates contract provisions to representatives from healthcare payer companies and government agencies.
• Contacts payer companies via phone or correspondence and initiates request for payment.
• Performs appropriate follow up with Payer and gains commitment for payment.
• Escalates Payer lack of response and/or lack of payment within Payer organization as appropriate.
• Identifies and communicates contract interpretation issues and language discrepancies to leadership as appropriate.
• Identifies Payer company trends and communicates trends to supervisor for further action/escalation.
• Serves as a subject matter expert in Payer contract dispute resolution process.
• Practices and adheres to the "Code of Conduct" philosophy and "Mission and Value Statement"
• Other duties as assigned



KNOWLEDGE, SKILLS & ABILITIES
 
• Communication - communicates clearly and concisely, verbally and in writing.
• Persistence – comfortable pursuing, rebutting and escalating issues as appropriate.  
• Goal-oriented – holds him/herself accountable to achieving shared and personal goals.
• 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 high proficiency in Microsoft Office applications and others as required.
• Policies & Procedures - demonstrates knowledge and understanding of organizational policies,
procedures and systems.
• Mathematical skills - able to perform advanced mathematical calculations and balance and reconcile figures
• Writing skills –advanced writing skills with ability to present a compelling argument, punctuate properly, spell correctly and transcribe accurately.

Job Requirements

EDUCATION  
 
• Bachelor’s degree required.
• Master’s degree preferred.


EXPERIENCE


• Two years of related experience preferred.
 
 
Parallon is an industry leader in revenue cycle services. We partner with over 650 hospitals and 2,400 physician practices nation-wide. Our parent company, HCA Healthcare has been consistently named a World’s Most Ethical Company by Ethisphere and is ranked in the Fortune 100. We are dedicated to ensuring our patients have the best experience even after they leave our facilities. 
 
#ParallonBCOM 


We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.

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