Virtual Prebill Denials Nurse Part Time in Norcross, GA at Parallon

Date Posted: 9/10/2018

Job Snapshot

Job Description

Parallon, a leading health care company is offering a great opportunity. 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