Description

Introduction

Do you want to join an organization that invests in you as a Payer Engagement Analyst? At HCA Healthcare, 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.

Benefits

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

• Comprehensive 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 (https://careers.hcahealthcare.com/pages/employee-benefits-and-rewards)

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 Payer Engagement Analyst like you to be a part of our team.

Job Summary and Qualifications

At the direction of the Director of Operations: participate in the strategic resolution and prevention of denials, payment discrepancies and other claims adjudication issues from HCA’s managed care book of business.

Note: This is a position requiring an understanding of payer contracts, policies and HCA’s internal tools and data bases.

General Responsibilities:

• The primary responsibility of the Analyst to identify the root cause and ways to mitigate denials, and payment discrepancies in the Managed Commercial, Exchange, Managed Medicare and Managed Medicaid books of business that consists of 3700 contracts and generating over 15B in revenue.

• The Analyst will support the HUB in its successful engagement between payers and Parallon/HCA on all underpayments, overpayments and denial activity resulting from contract and payer policy interpretation variances, as well as rate load model and modeling variances.

• The Analyst will be responsible for attending SSC payer calls (according to HUB rollout), and preparing for and participating in national payer meetings.

• The Analyst will participate in the HUB’s involvement in denial management activities, primarily focused on information gathering, but also resolution (via JOCs and other problem-solving interfacing with the MCOs) and disputes management.

• The Analyst will practice and adhere to HCA’s mission and values statement and code of conduct, and attend all required ethics and compliance training and retraining (including but not limited to Code of Conduct, Information Protection and Physician Relationship requirements).

• The Analyst will perform other duties as may be assigned or requested by the SVP, VP, Division CEO, Division CFO, ASD and hospital leadership.

Must Have:

• 3+ Years of relevant experience

• High School Graduate

• Managed Care or Revenue Cycle experience, specifically in the areas of financial analysis, payment methodologies, contract language and negotiations.

• The candidate must be fluent in such systems as Word (including editing documents via redline features), Excel, Pivot Point tables and PowerPoint presentations, etc.

HCA Healthcare (Corporate) , based in Nashville, Tennessee, supports a variety of corporate roles from business operations to administrative positions. Like our colleagues in any HCA Healthcare hospital, our corporate campus employees enjoy unparalleled resources and opportunities to reach their potential as healthcare leaders and innovators. From market rate compensation to continuing education and career advancement opportunities , every person has a solid foundation for success. Nashville is also home to our Executive Development Program , where exceptional employees are groomed to take on CNO- and COO-level roles in our hospitals. This selective program focuses on ethics, leadership and the financial and clinical knowledge required of professionals at this level of the industry.

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 Payer Engagement Analyst opening. Qualified candidates will be contacted for interviews. Submit your resume today to join our community of caring!

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.