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Job Details

Hospital Bill Audit Coordinator

Company name
Parallon Business Solutions

Location
Nashville, TN

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Job Description
Job Summary - Assist in managing and analyzing hospital bill audits by third party payers. Position will serve as liaison between payors, hospitals, and the Shared Service Center (SSC) regarding status of pending, ongoing and finalized audits. Position will evaluate the requests received by the payors to assess if the request is within the terms established by contracts and in accordance with the Hospital Bill Audit by Third Party Payers Policy. Position will notify appropriate responsible parties of reviews and maintain documentation of audit requests, current status, and outcomes of audits in a centralized location. Position will track and trend types of audits received and report findings to Manager. Supervisor – Revenue Integrity Director/Revenue Integrity Manager Supervises – N/A Duties (included but not limited to): • Interacts and coordinates handoffs of audits between responsible SSC departments such as Revenue Integrity for insurance charge audit reviews, HSC for coding or DRG related reviews and Ethics and Compliance and HCA – Regulatory Compliance Support (Regs) for government audits. Position will communicate with payor representatives related to audit request and coordination of audits to be performed. • Analyze and approve audit requests received from payors • Interact with payor to resolve questions or concerns related to coordination of audit request • Maintain tracking of audits and coordinate obtaining the medical record for auditor to perform on-site audits • Communicate approved and denied insurance defense audits • Maintain statistical data as required • Practice and adhere to the \Code of Conduct\ philosophy and \Mission and Value Statement\ • Other duties as assigned EDUCATION • Associate degree preferred; Equivalent work experience may substitute. EXPERIENCE • Three years of hospital business office or related financial experience preferred. • Project management and payor contract experience preferred. CERTIFICATE/ LICENSE - N/A  

Company info

Parallon Business Solutions
Website : http://parallon.com

Company Profile
Parallon’s roots are in the hallways of some of America’s top-performing hospitals and our commitment is to bring the expertise we have gained as operators to help you drive results. Parallon is dedicated to helping hospitals and health systems operate knowledgeably, intelligently, effectively and efficiently in the rapidly evolving healthcare marketplace, today and in the future.

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