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Appeals Resolution Specialist

  • Parallon Workforce
  • Covington, LA, USA
  • Jun 19, 2019

Job Description


SHIFT: Work From Home

SCHEDULE: Full-time

Appeals Resolution Specialist WFH

Work From Home

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.

Job Summary:

The Appeals Resolution Specialist (Internal Title: Appeals Specialist) is responsible for performing end to end tasks for technical appeals.

This is a Full-Time work from home opportunity, Monday thru Friday, 8:30am 5:00pm.

Duties (included but not limited to):

  • Triage incoming inventory for the Appeals team, validating appeal criteria is met

  • Compose technical denial arguments for reconsideration, including both written and telephonically

  • Identify contract protection that can be leveraged to overturn denials

  • Overcome objections that prevent payment of the claim and gain commitment for payment through concise and effective appeal argument

  • Identify problem accounts/processes/trends and escalate as appropriate

  • Utilize effective documentation standards that support a strong historical record of actions taken on the account.

  • Ability to perform basic math to ensure accurate statement of accounts receivable

  • High school diploma or GED required

  • Minimum one year of experience in related area required

We offer free parking, training support, competitive salary and excellent benefits to include several insurance package options for Medical, Dental and Vision; Paid Time Off for vacation, sick leave and holidays, Employer-paid Short Term Disability, Company matching 401K and more!

Parallon is an Equal Opportunity Employer (EOE), minority/ female/ veteran/ disabled, offering a great work environment, challenging career opportunities, and competitive compensation.