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Posted: Sunday, June 18, 2017 6:36 PM

Job Summary – The Prebill Denials Analyst will review post discharge, prebill accounts that do not have an
authorization on file, ALOS versus days authorized variances, and/or other account discrepancies identified that will
result in the account being denied by the payor that do not require a clinical review. Communicates with third party
payors to resolve discrepancies prior to billing. Accurately and concisely documents all communications and action taken
on the account in accordance with policies and procedures. The Prebill Denials Analyst will escalate medical review
request and/or denial activities to the Prebill Denials Nurse.
Supervisor – Denials Director
Supervises – N/A
Functional areas:
 Verification of authorization on services post discharge, prebill
 Validating re-certification for additional days post discharge, prebill
 eRequest queues as determined during program implementation
Duties (included but not limited to):
 Work prebill accounts identified via the Meditech reports efficiently and effectively on a daily basis to resolve
accounts with “no auth numbers and ALOS vs. authorized days variances
 Work assigned accounts in eRequest to resolve outstanding issues
 Report insurance denial trends identified during daily operational assignments
 Identify problem accounts and escalate as appropriate
 Document actions taken on the account clearly and concisely
 Contacting the facilities, physicians’ offices and/or insurance companies to resolve denials/appeals
 Adhere to time and attendance policies
 Adhere to all policies and procedures, including phone and internet usage, break utilization, etc.
 Participate in ongoing education and training as needed
 Establish and maintain relationships with all customers
 Seeks assistance from immediate supervisor when in situations which are unclear or ambiguous
 Adheres to established policy and procedure and escalates issues through the established Chain of Command
 Demonstrates commitment to teamwork and cooperation
 Practice and adhere to the “Code of Conduct” philosophy and “Mission and Value Statement”
 Other duties as assigned

Click here for more info: https://hca.taleo.net/careersection/0hca/jobdetail.ftl?job=26511-132882&lang=en


• Location: North DFW

• Post ID: 51032403 northdfw
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