Conifer Health Solutions
Credit Resolution Representative - Remote
Conifer Health Solutions, Frisco, Texas, United States, 75034
Credit Resolution Representative - Remote
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Credit Resolution Representative - Remote
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Conifer Health Solutions
Job Summary Responsible for performing the refunds and credit analyses functions within the Hospital Revenue Cycle Management team.
Essential Duties and Responsibilities
Performs refund and credit analyses, audit and reimbursement functions for all Managed Care, Commercial, Medicare, Medicaid, Self-pay and third party payors for all patient accounts. Determines if credit balance is an over contractual, late charges applied, overpayment etc. to ensure appropriate actions are taken to resolve.
Performs Quarterly reviews for Medicare and Medicaid (based on state guidelines) and submits to client for approval, signature and submission.
Manage and maintain desk inventory, complete reports, and resolve high priority and aged inventory. Accurately and thoroughly documents the pertinent credit balance review activity performed.
Communicate issues to management, including payer, system or escalated account issues.
Handle correspondence received from payers and patients requesting refunds. Respond timely to emails and telephone messages as appropriate.
Participate and attend meetings, training seminars and in-services to develop job knowledge.
Other duties as assigned by Management.
Knowledge, Skills, Abilities
Entry level understanding of hospital billing form requirements (UB04 and HCFA 1500)
Entry level knowledge of ACE/PBAR/STAR/Meditech or EPIC preferred
Entry level knowledge of ICD-10, HCPCS/CPT coding and medical terminology
Entry level writing skills
Contract Interpretation skills greatly preferred
Understanding and interpretation of Managed Care contracts
Understanding of Gov’t Medicare and multiple state Medicaid programs payor regulations (if Gov’t team)
Education / Experience
High School Diploma or equivalent experience, preferred.
1 – 3 years’ experience in a hospital business environment performing billing and/or follow-up functions, preferred.
Physical Demands
Ability to sit and work at a computer terminal for extended periods of time
Work Environment
Call Center environment with multiple workstations in close proximity.
Some positions may be eligible for Telecommuting based off Business need or position function. If eligible, all Telecommuting guidelines must be adhered to at all times.
Compensation
Pay: $17.20 - $25.70 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
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.
Equal Employment Opportunity 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.
Seniority Level Associate
Employment Type Full-time
Job Function Accounting/Auditing and Finance
Industries Hospitals and Health Care and Medical Practices
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Credit Resolution Representative - Remote
role at
Conifer Health Solutions
Job Summary Responsible for performing the refunds and credit analyses functions within the Hospital Revenue Cycle Management team.
Essential Duties and Responsibilities
Performs refund and credit analyses, audit and reimbursement functions for all Managed Care, Commercial, Medicare, Medicaid, Self-pay and third party payors for all patient accounts. Determines if credit balance is an over contractual, late charges applied, overpayment etc. to ensure appropriate actions are taken to resolve.
Performs Quarterly reviews for Medicare and Medicaid (based on state guidelines) and submits to client for approval, signature and submission.
Manage and maintain desk inventory, complete reports, and resolve high priority and aged inventory. Accurately and thoroughly documents the pertinent credit balance review activity performed.
Communicate issues to management, including payer, system or escalated account issues.
Handle correspondence received from payers and patients requesting refunds. Respond timely to emails and telephone messages as appropriate.
Participate and attend meetings, training seminars and in-services to develop job knowledge.
Other duties as assigned by Management.
Knowledge, Skills, Abilities
Entry level understanding of hospital billing form requirements (UB04 and HCFA 1500)
Entry level knowledge of ACE/PBAR/STAR/Meditech or EPIC preferred
Entry level knowledge of ICD-10, HCPCS/CPT coding and medical terminology
Entry level writing skills
Contract Interpretation skills greatly preferred
Understanding and interpretation of Managed Care contracts
Understanding of Gov’t Medicare and multiple state Medicaid programs payor regulations (if Gov’t team)
Education / Experience
High School Diploma or equivalent experience, preferred.
1 – 3 years’ experience in a hospital business environment performing billing and/or follow-up functions, preferred.
Physical Demands
Ability to sit and work at a computer terminal for extended periods of time
Work Environment
Call Center environment with multiple workstations in close proximity.
Some positions may be eligible for Telecommuting based off Business need or position function. If eligible, all Telecommuting guidelines must be adhered to at all times.
Compensation
Pay: $17.20 - $25.70 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
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.
Equal Employment Opportunity 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.
Seniority Level Associate
Employment Type Full-time
Job Function Accounting/Auditing and Finance
Industries Hospitals and Health Care and Medical Practices
#J-18808-Ljbffr