Underpayment 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 Underpayment Resolution Manager is responsible for managing activities related to analysis and collection of verified insurance underpayments. 

Duties (included but not limited to): 
• Manage daily activities related to SSC underpayment resolution functions, ensuring processes are performed efficiently and effectively 
• Ensure that underpayment discrepancies are collected timely and accurately 
• Meet with payers to resolve ongoing payment resolution issues 
• Coordinate with all necessary departments on contract issues related to underpayment discrepancies 
• Analyze trends in underpayment inventory and work with insurance companies to resolve underlying reasons 
• Perform QA for all processes within the Underpayment Resolution area 
• 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 underpayment resolutions staff 
• Conduct monthly staff meetings. 
• 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