Inpatient Authorization Review Services Specialist

Description

This Work from Home position requires that you live and will perform the duties of the position; within 60 miles of an HCA Healthcare Hospital (Our hospitals are located in the following states: FL, GA, , KS, KY, MO, NV, NH, NC, SC, TN, TX, UT, VA).

Do you want to join an organization that invests in you as a Inpatient Authorization Review Specialist? At Parallon, you come first. HCA Healthcare has committed up to $300 million in programs to support our incredible team members over the course of three years.

Parallon offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:

• Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free Air Med medical transportation.
• Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.
• Free counseling services and resources for emotional, physical and financial wellbeing
• 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)
• Employee Stock Purchase Plan with 10% off HCA Healthcare stock
• Family support through fertility and family building benefits with Progyny and adoption assistance.
• Referral services for child, elder and pet care, home and auto repair, event planning and more
• Consumer discounts through Abenity and Consumer Discounts
• Retirement readiness, rollover assistance services and preferred banking partnerships
• Education assistance (tuition, student loan, certification support, dependent scholarships)
• Colleague recognition program
• Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)
• Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.

Learn more about Employee Benefits ()

Eligibility for benefits may vary by location.

You contribute to our success. Every role has an impact on our patients’ lives and you have the opportunity to make a difference. We are looking for a dedicated Inpatient Authorization Review Specialist like you to be a part of our team.

The Inpatient Authorization Review Specialist 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 that do not require a clinical review. Communicate with third party payors to resolve discrepancies prior to billing. Accurately and concisely documents all communications and action taken on the account in accordance with policies and procedures.

The IPAT Analyst will escalate medical review request and/or denial activities to the IPAT Clinical Analyst.

• Work prebill accounts imported into the PDU Tool efficiently and effectively daily to resolve accounts with “no auth numbers and ALOS vs. authorized days variances.
• Work assigned accounts in eRequest to resolve outstanding issues.
• Report insurance denial trends identified during daily operational assignments.
• Identify problem accounts and elevate as appropriate.
• Document actions taken on the account clearly and concisely.
• Contacting the facilities, physicians’ offices and/or insurance companies to resolve denials/appeals.
• Adhere to time and attendance policies.
• Adhere to all policies and procedures, including phone and internet usage, break utilization, etc.
• Participate in ongoing education and training as needed.
• Establish and maintain relationships with all customers.
• Seeks assistance from immediate supervisor when in situations which are unclear or ambiguous.
• Adheres to established policy and procedural and escalates issues through the…