Description

The estimate displayed represents the typical wage range of candidates hired. Factors that may be used to determine your actual salary may include your specific skills, how many years of experience you have and comparison to other employees already in this role. The typical candidate is hired below midpoint of the range.

Introduction

Are you looking for a work environment where diversity and inclusion thrive? Submit your application for our Claims Representative WFH opening with Work from Home today and find out what it truly means to be a part of the HCA Healthcare team.

Benefits

Work from Home, 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 telemedicine services and free AirMed 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.
  
• Fertility and family building benefits through Progyny
  
• Free counseling services and resources for emotional, physical and financial wellbeing
  
• Family support, including adoption assistance, child and elder care resources and consumer discounts
  
• 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)
  
• Employee Stock Purchase Plan
  
• Retirement readiness and rollover 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)
  

Learn more about Employee Benefits

Note: Eligibility for benefits may vary by location.

We are seeking a(an) Claims Representative WFH for our team to ensure that we continue to provide all patients with high quality, efficient care. Did you get into our industry for these reasons? We are an amazing team that works hard to support each other and are seeking a phenomenal addition like you who feels patient care is as meaningful as we do. We want you to apply!

Job Summary and Qualifications

As Claims Representative WFH you will process claim files for payment from Workmen’s Compensation, Automobile, Property and Casualty, and Health Insurers. Contact Attorneys to maximize client reimbursements for services and recover all monies properly owed to our clients.

What You Will Do in this Role:

• Identify viable payer(s) and obtain all necessary documentation to properly process the claim for payment including, when applicable, IBs, UBs, Medical Records, POs, EOBs when necessary.
• Coordinate benefits with all available payers to appropriately maximize the client’s recovery while minimizing the patient’s personal responsibility.
• Review and process for payment all claims, in which adequate billing information has been obtained, to the appropriate insurance carrier within 24 hours of receipt of said information.
• Correspond with patients, policyholders, insurers, police, witnesses or other parties involved in the accident, and attorneys to obtain additional, relevant information to support the claim for monies owed.
• Review status of litigated claims (if applicable) and confer with attorneys and third party carriers regarding case disposition.
• Converse with the insurer(s) and appeal when appropriate to guarantee that all available benefits are recovered and that claims are reimbursed at the appropriate/maximum level(s).
• Use the operating systems (FACS, SSI etc.) to perform timely processing and follow up on every claim from initial placement thru resolution.
• Professionally respond to customer inquiries and requests that may require extracting, synthesizing, and analyzing system data.
• Prepare account summaries, offers of compromise, pro ration of funds, and compile other relevant data.
• Remain current with all local, state and federal statutes and act within the limits of the law.
• Understand all specific billing requirements for each applicable state and payer for which you are responsible.
• Establish and maintain constructive working relationships with insurance carriers, clients, external business contacts and staff.
• All Claims Representatives must maintain the highest level of confidentiality and comply with all HIPAA regulations and Business Associate Agreements with its clients.
• Practices and adheres to the “Code of Conduct” philosophy and “Mission and Values Statement”
• Attend Privacy and Security Training as required by the HIPAA Awareness Program and comply with all guidelines, policies and procedures to assure sensitive or confidential information is protected in accordance with the HIPAA rules and regulations.
• Adheres to Code of Conduct.
• Performs other duties as assigned.

Qualifications:

• High School Diploma or GED Required
• 2 years of directly related industry experience
• Relevant education may substitute experience requirement.
• Must have experience in reading and understanding UB04 and HCFA forms.
• Experience in Workman’s Compensation and Motor Vehicle Claims processing
• This is a work from home position that requires high-speed internet with 25 MB Download and 6 MB Upload. Wifi is not permitted.

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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.

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"Across HCA Healthcare’s more than 2,000 sites of care, our nurses and colleagues have a positive impact on patients, communities and healthcare.
Together, we uplift and elevate our purpose to give people a healthier tomorrow."- Jane Englebright, PhD, RN CENP, FAAN
Senior Vice President and Chief Nursing Executive

If you find this opportunity compelling, we encourage you to apply for our Claims Representative WFH opening. We promptly review all applications. Highly qualified candidates will be directly contacted by a member of our team. We are interviewing apply today!

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