Accounts Receivable Specialist jobs at HCA Healthcare - 55 jobs

Responsible for validating dispute reasons following Explanation of Benefits (EOB) review, escalating payment variance trends or issues to NIC management, and generating appeals for denied or underpaid claims. ESSENTIAL DUTIES AND RESPONSIBILITIES Include the following. Others may be assigned. * Validate denial reasons and ensures coding in DCM is accurate and reflects the denial reasons. Coordinate with the Clinical Resource Center (CRC) for clinical consultations or account referrals when necessary, * Generate an appeal based on the dispute reason and contract terms specific to the payor. This includes online reconsiderations. * Follow specific payer guidelines for appeals submission * Escalate exhausted appeal efforts for resolution * Work payer projects as directed * Research contract terms/interpretation and compile necessary supporting documentation for appeals, Terms & Conditions for Internet enabled Managed Care System (IMaCS) adjudication issues, and referral to refund unit on overpayments. * Perform research and makes determination of corrective actions and takes appropriate steps to code the DCM system and route account appropriately. * Escalate denial or payment variance trends to NIC leadership team for payor escalation. KNOWLEDGE, SKILLS, ABILITIES To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. * Intermediate understanding of Explanation of Benefits form (EOB), Managed Care Contracts, Contract Language and Federal and State Requirements * Intermediate knowledge of hospital billing form requirements (UB-04) * Intermediate understanding of ICD-9, HCPCS/CPT coding and medical terminology * Intermediate Microsoft Office (Word, Excel) skills * Advanced business letter writing skills to include correct use of grammar and punctuation. Conifer requires its candidates, as applicable and as permitted by law, to obtain and provide confirmation of all required vaccinations and screenings prior to the start of employment. This may include, but is not limited to, the COVID-19 vaccination, influenza vaccination, and/or any future required vaccines and screenings. EDUCATION / EXPERIENCE Include minimum education, technical training, and/or experience preferred to perform the job. * High School Diploma or equivalent, some college coursework preferred * 3 - 5 years experience in a hospital business environment performing billing and/or collections PHYSICAL DEMANDS The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. * Ability to sit and work at a computer terminal for extended periods of time WORK ENVIRONMENT The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. * Call Center environment with multiple workstations in close proximity As a part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions nationwide. We help our clients strengthen their financial and clinical performance, serve their communities, and succeed at the business of healthcare. Conifer Health helps organizations transition from volume to value-based care, enhance the consumer and patient healthcare experience and improve quality, cost, and access to healthcare. Are you ready to be part of our solutions? Welcome to the company that gives you the resources and incentives to redefine healthcare services, with a competitive benefits package and leadership to take your career to the next step! Compensation and Benefit Information Compensation * Pay: $18.60 - $28.00 per hour. Compensation depends on location, qualifications, and experience. * Position may be eligible for a signing bonus for qualified new hires, subject to employment status. * Conifer observed holidays receive time and a half. Benefits Conifer offers the following benefits, subject to employment status: * Medical, dental, vision, disability, and life insurance * Paid time off (vacation & sick leave) - min of 12 days per year, accrue at a rate of approximately 1.84 hours per 40 hours worked. * 401k with up to 6% employer match * 10 paid holidays per year * Health savings accounts, healthcare & dependent flexible spending accounts * Employee Assistance program, Employee discount program * Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, AD&D, auto & home insurance. * For Colorado employees, Conifer offers paid leave in accordance with Colorado's Healthy Families and Workplaces Act. Employment practices will not be influenced or affected by an applicant's or employee's race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship. Tenet participates in the E-Verify program. Follow the link below for additional information. E-Verify: ***************************** The employment practices of Tenet Healthcare and its companies comply with all applicable laws and regulations. **********

Provides lead level support for medical records collection activities. Responsible for quality improvement activities including outreach to providers for collection of medical records for Healthcare Effectiveness Data and Information Set (HEDIS) specific data collection, projects and audit processes. Contributes to overarching strategy to provide quality and cost-effective member care. **Essential Job Duties** - Outreaches to providers via phone call, fax, mail, electronic medical record system (EMR) retrieval, and direct on-site pick up for collection of medical records. - Loads medical records and reports from provider offices into the Healthcare Effectiveness Data and Information Set (HEDIS) application. - Provides subject matter expertise in project management/coordination of identification, pursuit and collection of medical records and other data in collaboration with other HEDIS staff. - Supports annual HEDIS audit and other like audits, and organizes provider outreach, pursuit, collection and upload of provider medical records into the internal database. Subject matter expert in the area of collecting medical records and reports from provider offices, loads data into the HEDIS application. - Assists the medical records leadership and quality improvement staff with physician and member interventions and incentive efforts as needed through review of medical records documentation. - Provides mentorship and leadership to team members and represents as lead on process and project improvement initiatives. - Participates in and prepares feedback for meetings with vendors related to the medical record collection process. - Some medical records collection related travel may be required. **Required Qualifications** + At least 4 years of health care experience, including medical records support experience in a managed care setting, or equivalent combination of relevant education and experience. + Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements. + Latest Centers for Medicare and Medicaid Services (CMS) and American Hospital Association (AHA) clinic coding knowledge. + Ability to maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA). + Knowledge of Healthcare Effectiveness Data and Information Set (HEDIS) and National Committee for Quality Assurance (NCQA). + Proficiency with data analysis tools (e.g., Excel). + Excellent customer service and active listening skills. + Previous project coordination and/or process improvement experience. + Ability to effectively interface with staff, clinicians, and leadership. + Strong prioritization skills and detail orientation. + Strong verbal and written communication skills, including professional phone etiquette. + Microsoft Office suite/applicable software program(s) proficiency. **Preferred Qualifications** - Registered Health Information Technician (RHIT). - Healthcare Effectiveness Data Information Set (HEDIS) data collection experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.65 - $38.37 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Provides lead level support for medical records collection activities. Responsible for quality improvement activities including outreach to providers for collection of medical records for Healthcare Effectiveness Data and Information Set (HEDIS) specific data collection, projects and audit processes. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties * Outreaches to providers via phone call, fax, mail, electronic medical record system (EMR) retrieval, and direct on-site pick up for collection of medical records. * Loads medical records and reports from provider offices into the Healthcare Effectiveness Data and Information Set (HEDIS) application. * Provides subject matter expertise in project management/coordination of identification, pursuit and collection of medical records and other data in collaboration with other HEDIS staff. * Supports annual HEDIS audit and other like audits, and organizes provider outreach, pursuit, collection and upload of provider medical records into the internal database. Subject matter expert in the area of collecting medical records and reports from provider offices, loads data into the HEDIS application. * Assists the medical records leadership and quality improvement staff with physician and member interventions and incentive efforts as needed through review of medical records documentation. * Provides mentorship and leadership to team members and represents as lead on process and project improvement initiatives. * Participates in and prepares feedback for meetings with vendors related to the medical record collection process. * Some medical records collection related travel may be required. Required Qualifications * At least 4 years of health care experience, including medical records support experience in a managed care setting, or equivalent combination of relevant education and experience. * Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements. * Latest Centers for Medicare and Medicaid Services (CMS) and American Hospital Association (AHA) clinic coding knowledge. * Ability to maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA). * Knowledge of Healthcare Effectiveness Data and Information Set (HEDIS) and National Committee for Quality Assurance (NCQA). * Proficiency with data analysis tools (e.g., Excel). * Excellent customer service and active listening skills. * Previous project coordination and/or process improvement experience. * Ability to effectively interface with staff, clinicians, and leadership. * Strong prioritization skills and detail orientation. * Strong verbal and written communication skills, including professional phone etiquette. * Microsoft Office suite/applicable software program(s) proficiency. Preferred Qualifications * Registered Health Information Technician (RHIT). * Healthcare Effectiveness Data Information Set (HEDIS) data collection experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.65 - $38.37 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Provides lead level support for medical records collection activities. Responsible for quality improvement activities including outreach to providers for collection of medical records for Healthcare Effectiveness Data and Information Set (HEDIS) specific data collection, projects and audit processes. Contributes to overarching strategy to provide quality and cost-effective member care. **Essential Job Duties** - Outreaches to providers via phone call, fax, mail, electronic medical record system (EMR) retrieval, and direct on-site pick up for collection of medical records. - Loads medical records and reports from provider offices into the Healthcare Effectiveness Data and Information Set (HEDIS) application. - Provides subject matter expertise in project management/coordination of identification, pursuit and collection of medical records and other data in collaboration with other HEDIS staff. - Supports annual HEDIS audit and other like audits, and organizes provider outreach, pursuit, collection and upload of provider medical records into the internal database. Subject matter expert in the area of collecting medical records and reports from provider offices, loads data into the HEDIS application. - Assists the medical records leadership and quality improvement staff with physician and member interventions and incentive efforts as needed through review of medical records documentation. - Provides mentorship and leadership to team members and represents as lead on process and project improvement initiatives. - Participates in and prepares feedback for meetings with vendors related to the medical record collection process. - Some medical records collection related travel may be required. **Required Qualifications** + At least 4 years of health care experience, including medical records support experience in a managed care setting, or equivalent combination of relevant education and experience. + Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements. + Latest Centers for Medicare and Medicaid Services (CMS) and American Hospital Association (AHA) clinic coding knowledge. + Ability to maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA). + Knowledge of Healthcare Effectiveness Data and Information Set (HEDIS) and National Committee for Quality Assurance (NCQA). + Proficiency with data analysis tools (e.g., Excel). + Excellent customer service and active listening skills. + Previous project coordination and/or process improvement experience. + Ability to effectively interface with staff, clinicians, and leadership. + Strong prioritization skills and detail orientation. + Strong verbal and written communication skills, including professional phone etiquette. + Microsoft Office suite/applicable software program(s) proficiency. **Preferred Qualifications** - Registered Health Information Technician (RHIT). - Healthcare Effectiveness Data Information Set (HEDIS) data collection experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.65 - $38.37 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Provides lead level support for medical records collection activities. Responsible for quality improvement activities including outreach to providers for collection of medical records for Healthcare Effectiveness Data and Information Set (HEDIS) specific data collection, projects and audit processes. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties * Outreaches to providers via phone call, fax, mail, electronic medical record system (EMR) retrieval, and direct on-site pick up for collection of medical records. * Loads medical records and reports from provider offices into the Healthcare Effectiveness Data and Information Set (HEDIS) application. * Provides subject matter expertise in project management/coordination of identification, pursuit and collection of medical records and other data in collaboration with other HEDIS staff. * Supports annual HEDIS audit and other like audits, and organizes provider outreach, pursuit, collection and upload of provider medical records into the internal database. Subject matter expert in the area of collecting medical records and reports from provider offices, loads data into the HEDIS application. * Assists the medical records leadership and quality improvement staff with physician and member interventions and incentive efforts as needed through review of medical records documentation. * Provides mentorship and leadership to team members and represents as lead on process and project improvement initiatives. * Participates in and prepares feedback for meetings with vendors related to the medical record collection process. * Some medical records collection related travel may be required. Required Qualifications * At least 4 years of health care experience, including medical records support experience in a managed care setting, or equivalent combination of relevant education and experience. * Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements. * Latest Centers for Medicare and Medicaid Services (CMS) and American Hospital Association (AHA) clinic coding knowledge. * Ability to maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA). * Knowledge of Healthcare Effectiveness Data and Information Set (HEDIS) and National Committee for Quality Assurance (NCQA). * Proficiency with data analysis tools (e.g., Excel). * Excellent customer service and active listening skills. * Previous project coordination and/or process improvement experience. * Ability to effectively interface with staff, clinicians, and leadership. * Strong prioritization skills and detail orientation. * Strong verbal and written communication skills, including professional phone etiquette. * Microsoft Office suite/applicable software program(s) proficiency. Preferred Qualifications * Registered Health Information Technician (RHIT). * Healthcare Effectiveness Data Information Set (HEDIS) data collection experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.65 - $38.37 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Provides lead level support for medical records collection activities. Responsible for quality improvement activities including outreach to providers for collection of medical records for Healthcare Effectiveness Data and Information Set (HEDIS) specific data collection, projects and audit processes. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties * Outreaches to providers via phone call, fax, mail, electronic medical record system (EMR) retrieval, and direct on-site pick up for collection of medical records. * Loads medical records and reports from provider offices into the Healthcare Effectiveness Data and Information Set (HEDIS) application. * Provides subject matter expertise in project management/coordination of identification, pursuit and collection of medical records and other data in collaboration with other HEDIS staff. * Supports annual HEDIS audit and other like audits, and organizes provider outreach, pursuit, collection and upload of provider medical records into the internal database. Subject matter expert in the area of collecting medical records and reports from provider offices, loads data into the HEDIS application. * Assists the medical records leadership and quality improvement staff with physician and member interventions and incentive efforts as needed through review of medical records documentation. * Provides mentorship and leadership to team members and represents as lead on process and project improvement initiatives. * Participates in and prepares feedback for meetings with vendors related to the medical record collection process. * Some medical records collection related travel may be required. Required Qualifications * At least 4 years of health care experience, including medical records support experience in a managed care setting, or equivalent combination of relevant education and experience. * Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements. * Latest Centers for Medicare and Medicaid Services (CMS) and American Hospital Association (AHA) clinic coding knowledge. * Ability to maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA). * Knowledge of Healthcare Effectiveness Data and Information Set (HEDIS) and National Committee for Quality Assurance (NCQA). * Proficiency with data analysis tools (e.g., Excel). * Excellent customer service and active listening skills. * Previous project coordination and/or process improvement experience. * Ability to effectively interface with staff, clinicians, and leadership. * Strong prioritization skills and detail orientation. * Strong verbal and written communication skills, including professional phone etiquette. * Microsoft Office suite/applicable software program(s) proficiency. Preferred Qualifications * Registered Health Information Technician (RHIT). * Healthcare Effectiveness Data Information Set (HEDIS) data collection experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.65 - $38.37 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Provides lead level support for medical records collection activities. Responsible for quality improvement activities including outreach to providers for collection of medical records for Healthcare Effectiveness Data and Information Set (HEDIS) specific data collection, projects and audit processes. Contributes to overarching strategy to provide quality and cost-effective member care. **Essential Job Duties** - Outreaches to providers via phone call, fax, mail, electronic medical record system (EMR) retrieval, and direct on-site pick up for collection of medical records. - Loads medical records and reports from provider offices into the Healthcare Effectiveness Data and Information Set (HEDIS) application. - Provides subject matter expertise in project management/coordination of identification, pursuit and collection of medical records and other data in collaboration with other HEDIS staff. - Supports annual HEDIS audit and other like audits, and organizes provider outreach, pursuit, collection and upload of provider medical records into the internal database. Subject matter expert in the area of collecting medical records and reports from provider offices, loads data into the HEDIS application. - Assists the medical records leadership and quality improvement staff with physician and member interventions and incentive efforts as needed through review of medical records documentation. - Provides mentorship and leadership to team members and represents as lead on process and project improvement initiatives. - Participates in and prepares feedback for meetings with vendors related to the medical record collection process. - Some medical records collection related travel may be required. **Required Qualifications** + At least 4 years of health care experience, including medical records support experience in a managed care setting, or equivalent combination of relevant education and experience. + Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements. + Latest Centers for Medicare and Medicaid Services (CMS) and American Hospital Association (AHA) clinic coding knowledge. + Ability to maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA). + Knowledge of Healthcare Effectiveness Data and Information Set (HEDIS) and National Committee for Quality Assurance (NCQA). + Proficiency with data analysis tools (e.g., Excel). + Excellent customer service and active listening skills. + Previous project coordination and/or process improvement experience. + Ability to effectively interface with staff, clinicians, and leadership. + Strong prioritization skills and detail orientation. + Strong verbal and written communication skills, including professional phone etiquette. + Microsoft Office suite/applicable software program(s) proficiency. **Preferred Qualifications** - Registered Health Information Technician (RHIT). - Healthcare Effectiveness Data Information Set (HEDIS) data collection experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.65 - $38.37 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Provides lead level support for medical records collection activities. Responsible for quality improvement activities including outreach to providers for collection of medical records for Healthcare Effectiveness Data and Information Set (HEDIS) specific data collection, projects and audit processes. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties * Outreaches to providers via phone call, fax, mail, electronic medical record system (EMR) retrieval, and direct on-site pick up for collection of medical records. * Loads medical records and reports from provider offices into the Healthcare Effectiveness Data and Information Set (HEDIS) application. * Provides subject matter expertise in project management/coordination of identification, pursuit and collection of medical records and other data in collaboration with other HEDIS staff. * Supports annual HEDIS audit and other like audits, and organizes provider outreach, pursuit, collection and upload of provider medical records into the internal database. Subject matter expert in the area of collecting medical records and reports from provider offices, loads data into the HEDIS application. * Assists the medical records leadership and quality improvement staff with physician and member interventions and incentive efforts as needed through review of medical records documentation. * Provides mentorship and leadership to team members and represents as lead on process and project improvement initiatives. * Participates in and prepares feedback for meetings with vendors related to the medical record collection process. * Some medical records collection related travel may be required. Required Qualifications * At least 4 years of health care experience, including medical records support experience in a managed care setting, or equivalent combination of relevant education and experience. * Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements. * Latest Centers for Medicare and Medicaid Services (CMS) and American Hospital Association (AHA) clinic coding knowledge. * Ability to maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA). * Knowledge of Healthcare Effectiveness Data and Information Set (HEDIS) and National Committee for Quality Assurance (NCQA). * Proficiency with data analysis tools (e.g., Excel). * Excellent customer service and active listening skills. * Previous project coordination and/or process improvement experience. * Ability to effectively interface with staff, clinicians, and leadership. * Strong prioritization skills and detail orientation. * Strong verbal and written communication skills, including professional phone etiquette. * Microsoft Office suite/applicable software program(s) proficiency. Preferred Qualifications * Registered Health Information Technician (RHIT). * Healthcare Effectiveness Data Information Set (HEDIS) data collection experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.65 - $38.37 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Provides lead level support for medical records collection activities. Responsible for quality improvement activities including outreach to providers for collection of medical records for Healthcare Effectiveness Data and Information Set (HEDIS) specific data collection, projects and audit processes. Contributes to overarching strategy to provide quality and cost-effective member care. **Essential Job Duties** - Outreaches to providers via phone call, fax, mail, electronic medical record system (EMR) retrieval, and direct on-site pick up for collection of medical records. - Loads medical records and reports from provider offices into the Healthcare Effectiveness Data and Information Set (HEDIS) application. - Provides subject matter expertise in project management/coordination of identification, pursuit and collection of medical records and other data in collaboration with other HEDIS staff. - Supports annual HEDIS audit and other like audits, and organizes provider outreach, pursuit, collection and upload of provider medical records into the internal database. Subject matter expert in the area of collecting medical records and reports from provider offices, loads data into the HEDIS application. - Assists the medical records leadership and quality improvement staff with physician and member interventions and incentive efforts as needed through review of medical records documentation. - Provides mentorship and leadership to team members and represents as lead on process and project improvement initiatives. - Participates in and prepares feedback for meetings with vendors related to the medical record collection process. - Some medical records collection related travel may be required. **Required Qualifications** + At least 4 years of health care experience, including medical records support experience in a managed care setting, or equivalent combination of relevant education and experience. + Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements. + Latest Centers for Medicare and Medicaid Services (CMS) and American Hospital Association (AHA) clinic coding knowledge. + Ability to maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA). + Knowledge of Healthcare Effectiveness Data and Information Set (HEDIS) and National Committee for Quality Assurance (NCQA). + Proficiency with data analysis tools (e.g., Excel). + Excellent customer service and active listening skills. + Previous project coordination and/or process improvement experience. + Ability to effectively interface with staff, clinicians, and leadership. + Strong prioritization skills and detail orientation. + Strong verbal and written communication skills, including professional phone etiquette. + Microsoft Office suite/applicable software program(s) proficiency. **Preferred Qualifications** - Registered Health Information Technician (RHIT). - Healthcare Effectiveness Data Information Set (HEDIS) data collection experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.65 - $38.37 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

JOB DESCRIPTION Job SummaryProvides senior level support for medical records collection activities. Responsible for quality improvement activities including outreach to providers for collection of medical records for Healthcare Effectiveness Data and Information Set (HEDIS) specific data collection, projects and audit processes. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties * Outreaches to providers via phone call, fax, mail, electronic medical record system retrieval and direct on-site pick up for collection of medical records. * Loads medical records and reports from provider offices into the Healthcare Effectiveness Data and Information Set (HEDIS) application. * Provides subject matter expertise in project management/coordination of identification, pursuit and collection of medical records and other data in collaboration with other HEDIS staff. * Supports annual HEDIS audit and other like audits, and organizes provider outreach, pursuit, collection and upload of provider medical records into the internal database. Subject matter expert in the area of collecting medical records and reports from provider offices, loads data into the HEDIS application. * Assists the medical records leadership and quality improvement staff with physician and member interventions and incentive efforts as needed through review of medical records documentation. * Provides mentorship and leadership to team members and represents at a senior level for process and project improvement initiatives. * Participates in and prepares feedback for meetings with vendors related to the medical record collection process. * Some medical records collection related travel may be required. Required Qualifications• At least 2 years of health care experience, including medical records support experience in a managed care setting, or equivalent combination of relevant education and experience. * Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements. * Knowledge of Healthcare Effectiveness Data and Information Set (HEDIS) and National Committee for Quality Assurance (NCQA). * Proficiency with data analysis tools (e.g., Excel). * Ability to manage files, schedules and information efficiently. * Ability to effectively interface with staff, clinicians, and leadership. * Strong prioritization skills and detail orientation. * Strong verbal and written communication skills, including professional phone etiquette. * Microsoft Office suite/applicable software program(s) proficiency, and ability to learn new programs. Preferred Qualifications * Registered Health Information Technician (RHIT). To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.65 - $34.88 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

JOB DESCRIPTION Job SummaryProvides senior level support for medical records collection activities. Responsible for quality improvement activities including outreach to providers for collection of medical records for Healthcare Effectiveness Data and Information Set (HEDIS) specific data collection, projects and audit processes. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties * Outreaches to providers via phone call, fax, mail, electronic medical record system retrieval and direct on-site pick up for collection of medical records. * Loads medical records and reports from provider offices into the Healthcare Effectiveness Data and Information Set (HEDIS) application. * Provides subject matter expertise in project management/coordination of identification, pursuit and collection of medical records and other data in collaboration with other HEDIS staff. * Supports annual HEDIS audit and other like audits, and organizes provider outreach, pursuit, collection and upload of provider medical records into the internal database. Subject matter expert in the area of collecting medical records and reports from provider offices, loads data into the HEDIS application. * Assists the medical records leadership and quality improvement staff with physician and member interventions and incentive efforts as needed through review of medical records documentation. * Provides mentorship and leadership to team members and represents at a senior level for process and project improvement initiatives. * Participates in and prepares feedback for meetings with vendors related to the medical record collection process. * Some medical records collection related travel may be required. Required Qualifications• At least 2 years of health care experience, including medical records support experience in a managed care setting, or equivalent combination of relevant education and experience. * Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements. * Knowledge of Healthcare Effectiveness Data and Information Set (HEDIS) and National Committee for Quality Assurance (NCQA). * Proficiency with data analysis tools (e.g., Excel). * Ability to manage files, schedules and information efficiently. * Ability to effectively interface with staff, clinicians, and leadership. * Strong prioritization skills and detail orientation. * Strong verbal and written communication skills, including professional phone etiquette. * Microsoft Office suite/applicable software program(s) proficiency, and ability to learn new programs. Preferred Qualifications * Registered Health Information Technician (RHIT). To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.65 - $34.88 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

JOB DESCRIPTION Job SummaryProvides senior level support for medical records collection activities. Responsible for quality improvement activities including outreach to providers for collection of medical records for Healthcare Effectiveness Data and Information Set (HEDIS) specific data collection, projects and audit processes. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties - Outreaches to providers via phone call, fax, mail, electronic medical record system retrieval and direct on-site pick up for collection of medical records. - Loads medical records and reports from provider offices into the Healthcare Effectiveness Data and Information Set (HEDIS) application. - Provides subject matter expertise in project management/coordination of identification, pursuit and collection of medical records and other data in collaboration with other HEDIS staff. - Supports annual HEDIS audit and other like audits, and organizes provider outreach, pursuit, collection and upload of provider medical records into the internal database. Subject matter expert in the area of collecting medical records and reports from provider offices, loads data into the HEDIS application. - Assists the medical records leadership and quality improvement staff with physician and member interventions and incentive efforts as needed through review of medical records documentation. - Provides mentorship and leadership to team members and represents at a senior level for process and project improvement initiatives. - Participates in and prepares feedback for meetings with vendors related to the medical record collection process. - Some medical records collection related travel may be required. Required Qualifications- At least 2 years of health care experience, including medical records support experience in a managed care setting, or equivalent combination of relevant education and experience. - Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements. - Knowledge of Healthcare Effectiveness Data and Information Set (HEDIS) and National Committee for Quality Assurance (NCQA). - Proficiency with data analysis tools (e.g., Excel). - Ability to manage files, schedules and information efficiently. - Ability to effectively interface with staff, clinicians, and leadership. - Strong prioritization skills and detail orientation. - Strong verbal and written communication skills, including professional phone etiquette. - Microsoft Office suite/applicable software program(s) proficiency, and ability to learn new programs. Preferred Qualifications - Registered Health Information Technician (RHIT). To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.65 - $34.88 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

JOB DESCRIPTION Job SummaryProvides support for medical records collection activities. Supports quality improvement activities through outreach to providers for collection of medical records for Healthcare Effectiveness Data and Information Set (HEDIS) specific data collection, projects and audit processes. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties - Outreaches to providers via phone call, fax, mail, electronic medical record system retrieval and direct on-site pick up for collection of medical records. - Loads medical records and reports from provider offices into the Healthcare Effectiveness Data and Information Set (HEDIS) application. - Supports annual HEDIS audit and other like audits, and organizes provider outreach, pursuit, collection and upload of provider medical records into the internal database. - Provides project management support to leadership via coordination, identification, pursuit and collection of medical records and other required data with other HEDIS staff. - Participates in meetings with vendors related to the medical record collection process. - Some medical records collection related travel may be required. Required Qualifications- At least 1 year customer service experience, preferably in an administrative support capacity in a health care setting, or equivalent combination of relevant education and experience. - Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements. - Excellent customer service and active listening skills. - Proficiency with data analysis tools (e.g., Excel). - Ability to manage files, schedules and information efficiently. - Ability to effectively interface with staff, clinicians, and leadership. - Strong prioritization skills and detail orientation. - Strong verbal and written communication skills, including professional phone etiquette. - Microsoft Office suite/applicable software program(s) proficiency, and ability to learn new programs. Preferred Qualifications - Registered Health Information Technician (RHIT). - Medical records collection experience. - Managed care experience. - Basic knowledge of Healthcare Effectiveness Data Information Set (HEDIS) and National Committee for Quality Assurance (NCQA). - Project planning experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.65 - $31.71 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

JOB DESCRIPTION Job SummaryProvides support for medical records collection activities. Supports quality improvement activities through outreach to providers for collection of medical records for Healthcare Effectiveness Data and Information Set (HEDIS) specific data collection, projects and audit processes. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties - Outreaches to providers via phone call, fax, mail, electronic medical record system retrieval and direct on-site pick up for collection of medical records. - Loads medical records and reports from provider offices into the Healthcare Effectiveness Data and Information Set (HEDIS) application. - Supports annual HEDIS audit and other like audits, and organizes provider outreach, pursuit, collection and upload of provider medical records into the internal database. - Provides project management support to leadership via coordination, identification, pursuit and collection of medical records and other required data with other HEDIS staff. - Participates in meetings with vendors related to the medical record collection process. - Some medical records collection related travel may be required. Required Qualifications- At least 1 year customer service experience, preferably in an administrative support capacity in a health care setting, or equivalent combination of relevant education and experience. - Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements. - Excellent customer service and active listening skills. - Proficiency with data analysis tools (e.g., Excel). - Ability to manage files, schedules and information efficiently. - Ability to effectively interface with staff, clinicians, and leadership. - Strong prioritization skills and detail orientation. - Strong verbal and written communication skills, including professional phone etiquette. - Microsoft Office suite/applicable software program(s) proficiency, and ability to learn new programs. Preferred Qualifications - Registered Health Information Technician (RHIT). - Medical records collection experience. - Managed care experience. - Basic knowledge of Healthcare Effectiveness Data Information Set (HEDIS) and National Committee for Quality Assurance (NCQA). - Project planning experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.65 - $31.71 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

JOB DESCRIPTION Job SummaryProvides support for medical records collection activities. Supports quality improvement activities through outreach to providers for collection of medical records for Healthcare Effectiveness Data and Information Set (HEDIS) specific data collection, projects and audit processes. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties - Outreaches to providers via phone call, fax, mail, electronic medical record system retrieval and direct on-site pick up for collection of medical records. - Loads medical records and reports from provider offices into the Healthcare Effectiveness Data and Information Set (HEDIS) application. - Supports annual HEDIS audit and other like audits, and organizes provider outreach, pursuit, collection and upload of provider medical records into the internal database. - Provides project management support to leadership via coordination, identification, pursuit and collection of medical records and other required data with other HEDIS staff. - Participates in meetings with vendors related to the medical record collection process. - Some medical records collection related travel may be required. Required Qualifications- At least 1 year customer service experience, preferably in an administrative support capacity in a health care setting, or equivalent combination of relevant education and experience. - Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements. - Excellent customer service and active listening skills. - Proficiency with data analysis tools (e.g., Excel). - Ability to manage files, schedules and information efficiently. - Ability to effectively interface with staff, clinicians, and leadership. - Strong prioritization skills and detail orientation. - Strong verbal and written communication skills, including professional phone etiquette. - Microsoft Office suite/applicable software program(s) proficiency, and ability to learn new programs. Preferred Qualifications - Registered Health Information Technician (RHIT). - Medical records collection experience. - Managed care experience. - Basic knowledge of Healthcare Effectiveness Data Information Set (HEDIS) and National Committee for Quality Assurance (NCQA). - Project planning experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.65 - $31.71 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

JOB DESCRIPTION Job SummaryProvides support for medical records collection activities. Supports quality improvement activities through outreach to providers for collection of medical records for Healthcare Effectiveness Data and Information Set (HEDIS) specific data collection, projects and audit processes. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties * Outreaches to providers via phone call, fax, mail, electronic medical record system retrieval and direct on-site pick up for collection of medical records. * Loads medical records and reports from provider offices into the Healthcare Effectiveness Data and Information Set (HEDIS) application. * Supports annual HEDIS audit and other like audits, and organizes provider outreach, pursuit, collection and upload of provider medical records into the internal database. * Provides project management support to leadership via coordination, identification, pursuit and collection of medical records and other required data with other HEDIS staff. * Participates in meetings with vendors related to the medical record collection process. * Some medical records collection related travel may be required. Required Qualifications * At least 1 year customer service experience, preferably in an administrative support capacity in a health care setting, or equivalent combination of relevant education and experience. * Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements. * Excellent customer service and active listening skills. * Proficiency with data analysis tools (e.g., Excel). * Ability to manage files, schedules and information efficiently. * Ability to effectively interface with staff, clinicians, and leadership. * Strong prioritization skills and detail orientation. * Strong verbal and written communication skills, including professional phone etiquette. * Microsoft Office suite/applicable software program(s) proficiency, and ability to learn new programs. Preferred Qualifications * Registered Health Information Technician (RHIT). * Medical records collection experience. * Managed care experience. * Basic knowledge of Healthcare Effectiveness Data Information Set (HEDIS) and National Committee for Quality Assurance (NCQA). * Project planning experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.65 - $31.71 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

The Collections Specialist I - HMO/PPO is responsible for performing collection follow-up on outstanding insurance balances, identifying claim issues, and ensuring timely resolution in compliance with government and managed care contract terms. This role requires effective communication with insurance payers, documentation of account activity, and adherence to applicable regulations to support revenue cycle operations. As a Collections Specialist I at Community Health Systems (CHS) - SSC Nashville, you'll play a vital role in supporting our purpose to help people get well and live healthier by providing safe, quality healthcare, building enduring relationships with our patients, and providing value for the people and communities we serve. Our team members enjoy a robust benefits package including medical, dental and vision, insurance, and 401k. **Benefits:** + Comprehensive Health Coverage - Medical, dental, and vision plans to keep you and your family healthy. + Future Security: 401(k) with matching + Student Loan Support - Up to $10,000 repayment assistance, because we invest in your future. + Educational Tuition Assistance + Competitive Pay & Full Benefits - A salary and package designed to reward your expertise and dedication. + Paid Time Off **Essential Functions** + Performs follow-up on outstanding insurance balances within the required timeframe, obtaining payment confirmation or required documentation. + Documents all actions taken on accounts within the appropriate system, ensuring a clear and traceable resolution process. + Makes the required number of outbound calls to insurance payers while maintaining professional and courteous communication. + Handles and resolves incoming correspondence within five days of receipt, updating the system with relevant information. + Analyzes assigned accounts using AS400, Meditech, Accurint, Cerner, directory assistance, and credit reports to maximize collection efforts. + Processes inbound and outbound calls professionally, providing exceptional customer service while resolving outstanding balances. + Ensures proper application of account dispositions and follows self-pay policies and procedures. + Adheres to all local, state, and federal laws and regulations, including FDCPA, TCPA, FCRA, CFPB, PCI, UDAAP, and HIPAA compliance standards. + Performs other duties as assigned. + Maintains regular and reliable attendance. + Complies with all policies and standards. **Qualifications** + H.S. Diploma or GED required + Associate Degree in Business, Finance, Healthcare Administration, or a related field preferred + 0-2 years of experience in medical collections, accounts receivable, billing, or healthcare revenue cycle operations required + Experience working with insurance follow-up, claim resolution, and payer communication in a healthcare setting preferred **Knowledge, Skills and Abilities** + Strong understanding of medical collections processes, payer reimbursement policies, and insurance claim resolution. + Proficiency in electronic medical record (EMR) systems, patient accounting systems, and collections software. + Knowledge of insurance contracts, denials management, and accounts receivable workflows. + Excellent problem-solving and analytical skills to research and resolve outstanding claims. + Effective verbal and written communication skills to interact with insurance payers, patients, and internal teams. + Strong attention to detail with the ability to document account activity accurately. + Ability to work independently in a fast-paced environment while meeting productivity and quality standards. + Knowledge of regulatory compliance, including HIPAA, FDCPA, and applicable healthcare finance laws. We know it's not just about finding a job. It's about finding a place where you are respected, valued and where your work is purposeful and fulfilling. A place where your talent is recognized, professional development is encouraged and career advancement is possible. The Shared Services Center - Nashville provides business office support functions like billing, insurance follow-up, call center customer service, data entry and more for hospitals and healthcare providers. But we're not only about work. We know employing a skilled and engaged team of professionals is vitally important to our success, so we make sure to offer competitive benefits, recognition programs, professional development opportunities and a fun and engaging team environment. Community Health Systems is one of the nation's leading healthcare providers. Developing and operating healthcare delivery systems in 40 distinct markets across 15 states, CHS is committed to helping people get well and live healthier. CHS operates 71 acute-care hospitals and more than 1,000 other sites of care, including physician practices, urgent care centers, freestanding emergency departments, occupational medicine clinics, imaging centers, cancer centers and ambulatory surgery centers. Equal Employment Opportunity This organization does not discriminate in any way to deprive any person of employment opportunities or otherwise adversely affect the status of any employee because of race, color, religion, sex, sexual orientation, genetic information, gender identity, national origin, age, disability, citizenship, veteran status, or military or uniformed services, in accordance with all applicable governmental laws and regulations. In addition, the facility complies with all applicable federal, state and local laws governing nondiscrimination in employment. This applies to all terms and conditions of employment including, but not limited to: hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. If you are an applicant with a mental or physical disability who needs a reasonable accommodation for any part of the application or hiring process, contact the director of Human Resources at the facility to which you are seeking employment; Simply go to ************************************************* to obtain the main telephone number of the facility and ask for Human Resources.

The Collections Specialist I - HMO/PPO is responsible for performing collection follow-up on outstanding insurance balances, identifying claim issues, and ensuring timely resolution in compliance with government and managed care contract terms. This role requires effective communication with insurance payers, documentation of account activity, and adherence to applicable regulations to support revenue cycle operations. As a Collections Specialist I at Community Health Systems (CHS) - SSC Nashville, you'll play a vital role in supporting our purpose to help people get well and live healthier by providing safe, quality healthcare, building enduring relationships with our patients, and providing value for the people and communities we serve. Our team members enjoy a robust benefits package including medical, dental and vision, insurance, and 401k. Benefits: Comprehensive Health Coverage - Medical, dental, and vision plans to keep you and your family healthy. Future Security: 401(k) with matching Student Loan Support - Up to $10,000 repayment assistance, because we invest in your future. Educational Tuition Assistance Competitive Pay & Full Benefits - A salary and package designed to reward your expertise and dedication. Paid Time Off Essential Functions Performs follow-up on outstanding insurance balances within the required timeframe, obtaining payment confirmation or required documentation. Documents all actions taken on accounts within the appropriate system, ensuring a clear and traceable resolution process. Makes the required number of outbound calls to insurance payers while maintaining professional and courteous communication. Handles and resolves incoming correspondence within five days of receipt, updating the system with relevant information. Analyzes assigned accounts using AS400, Meditech, Accurint, Cerner, directory assistance, and credit reports to maximize collection efforts. Processes inbound and outbound calls professionally, providing exceptional customer service while resolving outstanding balances. Ensures proper application of account dispositions and follows self-pay policies and procedures. Adheres to all local, state, and federal laws and regulations, including FDCPA, TCPA, FCRA, CFPB, PCI, UDAAP, and HIPAA compliance standards. Performs other duties as assigned. Maintains regular and reliable attendance. Complies with all policies and standards. Qualifications H.S. Diploma or GED required Associate Degree in Business, Finance, Healthcare Administration, or a related field preferred 0-2 years of experience in medical collections, accounts receivable, billing, or healthcare revenue cycle operations required Experience working with insurance follow-up, claim resolution, and payer communication in a healthcare setting preferred Knowledge, Skills and Abilities Strong understanding of medical collections processes, payer reimbursement policies, and insurance claim resolution. Proficiency in electronic medical record (EMR) systems, patient accounting systems, and collections software. Knowledge of insurance contracts, denials management, and accounts receivable workflows. Excellent problem-solving and analytical skills to research and resolve outstanding claims. Effective verbal and written communication skills to interact with insurance payers, patients, and internal teams. Strong attention to detail with the ability to document account activity accurately. Ability to work independently in a fast-paced environment while meeting productivity and quality standards. Knowledge of regulatory compliance, including HIPAA, FDCPA, and applicable healthcare finance laws. We know it's not just about finding a job. It's about finding a place where you are respected, valued and where your work is purposeful and fulfilling. A place where your talent is recognized, professional development is encouraged and career advancement is possible. The Shared Services Center - Nashville provides business office support functions like billing, insurance follow-up, call center customer service, data entry and more for hospitals and healthcare providers. But we're not only about work. We know employing a skilled and engaged team of professionals is vitally important to our success, so we make sure to offer competitive benefits, recognition programs, professional development opportunities and a fun and engaging team environment. Community Health Systems is one of the nation's leading healthcare providers. Developing and operating healthcare delivery systems in 40 distinct markets across 15 states, CHS is committed to helping people get well and live healthier. CHS operates 71 acute-care hospitals and more than 1,000 other sites of care, including physician practices, urgent care centers, freestanding emergency departments, occupational medicine clinics, imaging centers, cancer centers and ambulatory surgery centers.

**Introduction** Do you want to join an organization that invests in you as a Coding Account Resolution Specialist-Inpatient? 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. **This position is a work from home position!** **Some flexibility in the schedule!** **Benefits** 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 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. + 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 (********************************************************************** **_Note: 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 Coding Account Resolution Specialist-Inpatient like you to be a part of our team. **Job Summary and Qualifications** The Coding Account Resolution Specialist-III (CARS-III) works inpatient coding related alerts/edits, predominately post initial/final coding. The CARS-III performs the alert/edit resolution activities in the applicable systems. The alerts/edits shall be worked according to the established procedures and thresholds, and communicated as appropriate. **What you will do in this role:** + Compiles daily work list from eRequest, CRT and/or other alert/edit systems + Takes action and resolves alerts/edits daily following established procedures and thresholds + Enters detailed notes to update eRequest to provide details if the alert/edit cannot be resolved or must be rerouted to another responsible party for research/resolution + Escalates alert/edit resolution issues as appropriate to minimize final billing delays + Monitors the aging of accounts held by an alert/edit, prioritizes aged accounts first, and reports to leadership + Works with team members in billing, revenue integrity and/or the Medicare Service Center to resolve alerts/edits + Assigns interim DRGs for in-house patients at month end + Completes MOCK abstracts as necessary (e.g., combining the codes for outpatient and inpatient claims subject to the payment window) + Assists the Coding Leads and/or Coding Managers in resolving unbilled reason codes (URC)/Hold Reasons + Communicates coding revisions to the applicable party (e.g., CIS, lead, manager, international log) + Periodically works with their Manager to review individual work accomplishments, discuss work problems/barriers, discuss progress in mastering tasks and work processes, and discusses individual training needs and career progression + Adheres to all applicable coding and billing regulations and guidance, including but not limited to, CMS, AHA and HCA policies and guidelines + As needed, may periodically be asked to perform Coding Integrity Specialist III (CIS-III) duties + Meets all educational requirements as stated in Company and HSC policy + Reviews all official data quality standards, coding guidelines, Company policies and procedures and clinical/medical resources to assure coding knowledge and skills remain current + Practice and adhere to the Company's Code of Conduct philosophy + Practice and adhere to the Company's Mission and Values + Other duties as assigned **Qualifications:** + High School graduate or GED equivalent preferred, undergraduate (associates or bachelors) degree in HIM/HIT preferred + 1-year acute care inpatient coding experience require with 3 years' experience preferred + RHIA, RHIT and/or CCS preferred **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. " "Good people beget good people."- Dr. Thomas Frist, Sr. HCA Healthcare Co-Founder We are a family 270,000 dedicated professionals! Our Talent Acquisition team is reviewing applications for our Coding Account Resolution Specialist-Inpatient opening. Qualified candidates will be contacted for interviews. **Submit your resume today to join our community of caring!** 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.