As a part of the Tenet and Catholic Health Initiativesfamily, Conifer Health brings 30 years of healthcare industry expertise toclients in more than 135 local regions nationwide. We help our clientsstrengthen their financial and clinical performance, serve their communitiesand succeed at the business of healthcare. Conifer Health helps organizationstransition from volume to value-based care, enhance the consumer and patienthealthcare experience and improve quality, cost and access to healthcare. Are youready to be part of our solutions? Welcome to the company that gives you the resources and incentives toredefine healthcare services, with a competitive benefits package andleadership to take your career to the next step!
Responsible for all aspects of billing, follow up andcollection activity. Billingresponsibilities include manual re-bills as well as electronic submission topayers. Follow-up includes telephonecalls to payers and/or patients, as well as accessing payer websites, andresolving complex accounts with minimal or no assistance necessary. Participate and attend meetings, trainingseminars and in-services to develop job knowledge. Respond timely to emails and telephonemessages as appropriate. Identify,communicate and effectively work to resolve issues including payer, system orescalated account issues. Participateand assist in special projects as well as provide A/R support to the team.Assist new or existing staff with training or techniques to increase productionand quality as well as provide A/R support for the team members that may beabsent or backlogged.
ESSENTIAL DUTIES ANDRESPONSIBILITIESincludethe following. Other duties may be assigned.
Responsible for all aspects of insurancefollow up and collections, including making telephone calls, accessing payerwebsites and filing appeals. Effectivelyresolves complex or aged inventory, including payment research and paymentrecoups with minimal or no assistance necessary. Identify issues or trending and providesuggestions for resolution. Accuratelyand thoroughly documents the pertinent collection activity performed. Review the account information and necessarysystem applications to determine the next appropriate work activity. Verify claims adjudication utilizingappropriate resources and applications. Initiate telephone or letter contact to patients to obtain additionalinformation as needed. Performappropriate billing functions, including manual re-bills as well as electronicsubmission to payers. Edit claims tomeet and satisfy billing compliance guidelines for electronic submission. Manage and maintain desk inventory, completereports, and resolve high priority and aged inventory.
Participate and attend meetings,training seminars and in-services to develop job knowledge. Participate in themonthly, quarterly and annual performance evaluation process with theirSupervisor. Respond timely to emails andtelephone messages as appropriate. Identify and communicate issues to management, including payer, systemor escalated account issues as well as assist in the development ofsolutions. Assist with special projectsassigned by management as needed. Assistnew or existing staff with training or techniques to increase production andquality as well as provide A/R support for the team or team members that may beabsent or backlogged.
To perform this jobsuccessfully, an individual must be able to perform each essential dutysatisfactorily. The requirements listedbelow are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made toenable individuals with disabilities to perform the essential functions.
Good written and verbal communicationskills
Intermediate technical skills includingPC and MS Outlook
Advanced knowledge of UB-04 andExplanation of Benefits (EOB) interpretation
Intermediate knowledge of CPT and ICD-9codes
Advanced knowledge of insurance billing,collections and insurance terminology
EDUCATION / EXPERIENCE
Include minimumeducation, technical training, and/or experience required to perform the job.
High school diploma or equivalenteducation
2-5 yearsâ experience inMedical/Hospital Insurance related collections
The work environmentcharacteristics described here are representative of those an employeeencounters while performing the essential functions of this job. Reasonable accommodations may be made toenable individuals with disabilities to perform the essential functions.
Office/Team Work Environment
Primary Location: Frisco, Texas
Job Type: Full-time
Shift Type: Days
Employment practices will not be influenced or affected by an applicantâs or employeeâs 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.