Conifer Health Solutions is a leading healthcare business process management services provider working to improve operational performance for more than 600 clients so they can support financial improvement, enhance the patient experience, and drive value-based performance. Through our revenue cycle management, patient communications, and value-based care solutions, we empower healthcare decision makersâ��hospitals, health systems, physicians, self-insured employers, and payersâ��to better connect every point of care and wellness management. 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!
Responsible for providing direct support to AR/Disputes operations team, client, Conifer One team, and subcontracted external legal resources engaged in the collection and recovery of complex underpaid claims.
ESSENTIAL DUTIES AND RESPONSIBILITIES
Include the following. Others may be assigned.
In depth knowledge of applicable contracts. Ensure compliance with state and federal laws and regulations. Maintains a thorough understanding of health insurance and government programs, where necessary.
Acts as liaison between the Business Office, Legal Department, Client and outside counsel regarding outstanding litigations
Is a trusted advisor to internal and external customers
Prepare agenda and assist with facilitation of Client calls (weekly)
Prepares Dispute packages for assignment to law firms per Client instructions
Hold status update calls (bi-weekly/monthly) with law firms for assignment updates and inventory disposition
Works required reports (daily, weekly, monthly) to ensure legal payer issues are referred in a timely manner
Comfortable reviewing large data sets. Must possess ability to utilize data inferences to come up with process optimization and prioritization of tasks
Identify process improvement opportunities and assist with implementation
If direct report positions are listed below, the following responsibilities will be performed in accordance with guidelines, policies and procedures, and applicable laws. Supervisory responsibilities include interviewing, hiring, and training employees; planning, assigning and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.
No. Direct Reports (incl, titles): Patient Acct Reps, Sr Patient Acct Reps, Lead Patient Acct Reps, and Patient Acct Supervisors
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.
Advanced knowledge of healthcare A/R
Excellent working knowledge of Patient Financial Services operations with specific focus on Inpatient and Outpatient Managed Care and Commercial payors (i.e., Medicare regulations and compliance; HIPAA)
Proficient in Microsoft Office (Word and Excel)
Ability to provide advanced customer service
Ability to multi-task
Strong time management and organizational skills
Ability to research and work independently
Ability to communicate in a professional manner
Good written and verbal communication skills
Strong interpersonal skills
Strong technical skills, including PC and MS Office Suite knowledge
EDUCATION / EXPERIENCE
Include minimum education, technical training, and/or experience preferred to perform the job.
High school diploma or equivalent
Associate/Bachelor Degree preferred
Advanced excel skills is a plus
5+ yearsâ�� experience in medical billing, collections, appeals, legal department and/or contract interpretation
Employment practices will not be influenced or affected by an applicantâ��s or employeeâ��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 Healthcare Corporation (NYSE: THC) is a diversified healthcare services company headquartered in Dallas with 112,000 employees. Through an expansive care network that includes United Surgical Partners International, we operate 65 hospitals and approximately 510 other healthcare facilities, including surgical hospitals, ambulatory surgery centers, urgent care and imaging centers and other care sites and clinics. We also operate Conifer Health Solutions, which provides revenue cycle management and value-based care services to hospitals, health systems, physician practices, employers and other clients. Across the Tenet enterprise, we are united by our mission to deliver quality, compassionate care in the communities we serve.