HCA, Hospital Corporation of America Nurse Clinical Appeals Specialist in Richmond, Virginia
Parallon Business Performance Group has the following opportunity available with the Richmond Shared Services Center, 7300 Beaufont Springs Drive, Richmond, Virginia.
Nurse - Clinical Appeals Specialist
This applicant must be an RN or LPN with current state licensure and must be able to accommodate a Monday thru Friday work schedule, from 8:30AM to 5:00PM.
The Clinical Appeals Specialist will handle appeals requiring clinical input or interpretation as well as, monitor insurance denials.
Key responsibilities: * Run appropriate reports and contacting insurance companies to resolve claims denied for clinical reasons
Identify coding or clinical documentation issues and works to correct the errors in a timely manner
Identify problem accounts and escalate them as appropriate
Update patient account records to identify action taken on the account
Work with guarantors to secure payment on account balances outstanding for clinical reasons
You must have at least one year of case management experience required.
Associate’s degree preferred
We offer a convenient location, free parking, training support, competitive compensation, and excellent benefits that include several insurance packages to choose from, paid time off for vacation, sick leave and holidays, company matching 401K.
Parallon is an Equal Opportunity Employer (EOE), minority/Female/Veteran/Disabled, offering a great work environment, challenging career opportunities, and competitive compensation.
Title: Nurse Clinical Appeals Specialist
Location: Virginia-Richmond-Shared Services - Richmond
Requisition ID: 08648-125655