Are you looking for a work environment where diversity and inclusion thrive? Submit your application for our Revenue Cycle Operations CQR Specialist opening with Parallon today and find out what it truly means to be a part of the HCA Healthcare team.
Parallon, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:
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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.
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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.
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Free counseling services and resources for emotional, physical and financial wellbeing
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401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)
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Employee Stock Purchase Plan with 10% off HCA Healthcare stock
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Family support through fertility and family building benefits with Progyny and adoption assistance.
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Referral services for child, elder and pet care, home and auto repair, event planning and more
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Consumer discounts through Abenity and Consumer Discounts
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Retirement readiness, rollover assistance services and preferred banking partnerships
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Education assistance (tuition, student loan, certification support, dependent scholarships)
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Colleague recognition program
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Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)
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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.
We are seeking a Revenue Cycle Operations CQR Specialist 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!
The Revenue Cycle Operations Quality Review Specialist CODER performs internal quality assessment reviews on processes performed by international vendors to ensure compliance with Notice of Admission operational standards and policies in accordance to the vendor contract agreement. Analyze audit including coding criteria and guidelines in clinical denials and insurance claims. Quality reviews are communicated to the Parallon Revenue Cycle Operations Management team to improve accuracy and efficiency in workflow production and provide specific and ongoing education to vendors based on the quality monitoring review findings and trends.
Duties (included but are not limited to):
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Performs all functions of quality reviews and assessments of vendor processes performed by international vendors
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Review and trend account issues related to quality and provide feedback to Revenue Cycle Ops Manager
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Assists in ensuring vendors adhere to process and procedure according to vendor agreement
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Demonstrates and applies expert level of knowledge of revenue cycle processes and concepts
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Provide coding guidance and support on quality audit
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Assists Parallon on defining process flows and education, including but not limited to onboarding and training
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Maintains up-to-date knowledge of the business processes assigned to the international vendors
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Enforce all provisions of the international vendor contract
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Ensures safe, ergonomic and confidentiality compliant practices are being followed within the work environment
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Establishes and maintains good working relationships with international vendors, SSCs and Corporate team 1 Job Description
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Practice and adhere to the “Code of Conduct” philosophy and “Mission and Value Statement” • Other duties as assigned
Knowledge, Skills and Abilities:
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Certified Professional Coder
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Technical Expertise – strong knowledge of revenue cycle
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Strategic Analysis - analytical Review skills and ability to make decisions based on analysis
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Leadership - guides individuals and groups toward desired outcomes, setting high performance standards and delivering leading quality services
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Tactical execution - oversees the development, deployment, and direction of complex programs and processes to international vendors
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Financial management - applies tools and processes to successfully manage to budget
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Project Management - assesses work activities and allocates resources appropriately • Organization - proactively prioritizes needs and effectively manages resources
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Communication - communicates clearly and concisely, verbally and in writing, including utilizing proper punctuation and correct spelling; able to communicate with SSCs, Parallon Corporate team, and international vendors
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Customer orientation - establishes and maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations
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Interpersonal skills - able to work effectively with other employees, teams, and external parties
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PC skills - demonstrates proficiency in Microsoft Office applications and others as required
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Policies & Procedures - demonstrates knowledge and understanding of organizational policies, procedures, and systems
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Basic Skills – demonstrates ability to organize, perform and track multiple tasks accurately in short timeframes; able to work quickly and accurately in a fast-paced environment while managing multiple demands; able to work both independently and collaboratively as a team player; demonstrates adaptability, analytical and problem solving skills, and attention to detail; and able to perform basic mathematical calculations, balance and reconcile figures, and transcribe accurately
Education:
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High school diploma or GED is preferred.
Experience:
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3-4 years relevant experience; Revenue Cycle/SSC experience preferred. HCA-based system experience preferred.
Certificate/License:
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Coding certification through AHIMA or AAPC preferred.
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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 Revenue Cycle Operations CQR Specialist 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.