Senior Payment Compliance Analyst

Are you passionate about the patient experience? At HCA Healthcare, we are committed to caring for patients with purpose and integrity. We care like family! Jump-start your career as a Senior Payment Compliance Analyst today with HCA Healthcare.

Job Summary and Qualifications

Job Summary - The Sr. Payment Compliance Analyst will maintain the denial escalation database by tracking the current status for all inventory pursued by the Dispute Resolution and Denial Escalation Team. He/she will also assist with reconciling the Denial Escalation database statuses and legal updates between the Denial Escalation Team and the Litigation Team database. The Sr. Payment Compliance Analyst will work closely with the VP, Net Revenue Analytics and Dispute Resolution and Payer Analysis Director to provide responses to the litigation team on inventory that has been escalated to litigation. He/she will work with the Payer Analysis Director and Payer Analysis Ops/Sys Manager of Dispute Resolution to provide feedback and training to the Payment Compliance Analyst. The Sr. Payment Compliance Analyst will assist the Director of Dispute Resolution with developing and maintaining reporting tools necessary for monthly reporting to Corporate and SSC Leaders.

Supervisor - Payer Analysis Manager

Supervises - N/A

Duties (included but not limited to):

• Maintains workflow of Denial Escalation inventory between Dispute Resolution and Denial Escalation Team.
• Reconciles and maintains the DET Denial Escalation database with current account statuses and financials for all denial escalation inventory processing through the Denial Escalation Team workflow.
• Maintains workflow of Denial Escalation inventory between Dispute Resolution and HCA Litigation.
• Reconciles and maintains the DRT Denial Escalation database with the Litigation Denial Escalation database to ensure the most current status and legal updates are being reported.
• Maintains the Dispute Resolution Litigation mailbox which includes reviewing and formulating responses to internal and external counsel questions.
• Reviewing the weekly payment files for Dispute Resolution Denial Escalation inventory and coordinating with the SSC teams to ensure financials are stated correctly.
• Assist with monitoring and monthly reporting of denial escalation inventory.
• Assist Dispute Resolution department in gathering data for legal discovery.
• Work with Payment Compliance units to obtain additional supporting information as needed.
• Assist the Dispute Resolution Manager with training on denial escalation technical reviews as needed.
• Strong attention to detail in order to ensure the accuracy of the data being reported.
• Works quickly and efficiently in order to meet the needs of the customer particularly when faced with tight turnaround times.
• Minimal travel may be required.
• Other duties as assigned. Knowledge, Skills & Abilities
• Adaptability - maintains effectiveness when experiencing major changes in work tasks or the work environment; adjusts effectively to work within new work structures, processes, requirements, or cultures.
• Organization - stays focused and proactively prioritizes initiatives; determines tasks and resources, and schedules with keen ability to multi-task.
• Communication - communicates professionally, clearly, proactively, and concisely with all key stakeholders, both individually and in group settings.
• Customer orientation - establishes and maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations
• PC skills - Skilled in all Microsoft Office applications, including strong technical skills in Microsoft Excel (Intermediate to Advanced skill level); knowledge of Business objects, Essbase, SQL, and relational databases

EDUCATION

• Bachelor's Degree required.

EXPERIENCE

• Minimum 2-4 years relevant experience.
• Revenue Cycle/SSC experience preferred.
• HCA-based system experience preferred.

CERTIFICATE/LICENSE

• N/A

Benefits

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

• Comprehensive benefits for medical, prescription drug, dental, vision, behavioral health and telemedicine services
• Wellbeing support, including free counseling and referral services
• Time away from work programs for paid time off, paid family leave, long- and short-term disability coverage and leaves of absence
• Savings and retirement resources, including a 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service), Employee Stock Purchase Plan, flexible spending accounts, preferred banking partnerships, retirement readiness tools, rollover support and financial wellbeing counseling
• Education support through tuition assistance, student loan assistance, certification support, dependent scholarships and a partnership with Galen College of Nursing
• Additional benefits for fertility and family building, adoption assistance, life insurance, supplemental health protection plans, auto and home insurance, legal counseling, identity theft protection and consumer discounts

Learn more about Employee Benefits

Note: Eligibility for benefits may vary by location.

Parallon provides full-service revenue cycle management, or total patient account resolution, for HCA Healthcare. Our services include scheduling, registration, insurance verification, hospital billing, revenue integrity, collections, payment compliance, credentialing, health information management, customer service, payroll and physician billing. We also provide full-service revenue cycle management as well as targeted solutions, such as Medicaid Eligibility, for external clients across the country. Parallon has over 17,000 colleagues, and serves close to 1,000 hospitals and 3,000 physician practices, all making an impact on patients, providers and their communities.

HCA Healthcare has been recognized as one of the World's Most Ethical Companies by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated 3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.

"The great hospitals will always put the patient and the patients family first, and the really great institutions will provide care with warmth, compassion, and dignity for the individual."- Dr. Thomas Frist, Sr.

HCA Healthcare Co-Founder

If you are looking for an opportunity that provides satisfaction and personal growth, we encourage you to apply for our Senior Payment Compliance Analyst opening. We promptly review all applications. Highly qualified candidates will be contacted for interviews. Unlock the possibilities and apply today!

We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.