As a part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions nationwide. We help our clients strengthen their financial and clinical performance, serve their communities and succeed at the business of healthcare. Conifer Health helps organizations transition from volume to value-based care, enhance the consumer and patient healthcare experience and improve quality, cost and access to healthcare. 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 first level management of non-government support activities in the National Insurance Center (NIC).
ESSENTIAL DUTIES AND RESPONSIBILITIES
Include the following. Others may be assigned.
Ensures that all Mail is processed, appropriately, ensures certified and express mail are prioritized for daily production.
Ensures compliance with state and federal law regulations for Managed Care and other third party payors.
Develops or approves recommendations to change policies and procedures; ensures timely and accurate implementation.
Implements strategies for improving the TAT in processing mail, EDI reports, and DCM/CRC print.
Ensures all EDI reports are worked timely to optimize cash flow; Escalates and reports all trends that affect cash flow. Meets production standard of completing all EDI reports within 1 day of receipt.
Ensures DCM/CRC CIDï¿½s are worked and completed in a timely and efficient manner, meeting production goals of zero days by end of week.
Ensures hard copy billing is processed, efficiently and timely meeting production goals of 1 day unprocessed by end of week.
Completes QA on all areas of responsibility, documents and provides employee training as required.
Provides back up supervision for billing supervisor as needed for meetings, PTO, coverage.
This position carries out supervisory responsibilities 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.
Direct Reports (titles) Rep, Non-Government Billing Support Services II (varies by site)
Indirect Reports (titles) N/A
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.
Intermediate Microsoft Office (Word, Excel)
Intermediate knowledge of ICD9/CPT4 codes and payor requirements
Working knowledge of National Uniformed Billing Code, CPT/HCPC, ICD-9 and UB-04
Intermediate knowledge of HIPAA guidelines
Intermediate writing skills
Ability to multi-task
Strong leadership and organizational skills
EDUCATION / EXPERIENCE
Include minimum education, technical training, and/or experience required to perform the job.
4-year college degree in Business or Healthcare Administration preferred
3 -5 years of experience providing leadership and management direction related to areas in the Revenue Cycle, Billing, AR collections or Dispute Commercial processes within a multi-facility environment
Experience as a Patient Accounts Supervisor preferred
Experience with business process redesign desirable
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Must be able to work in sitting position, use computer and answer telephone
Ability to travel
Includes ability to walk through hospital-based departments across broad campus settings, including Emergency Department environments
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Call Center environment with multiple workstations in close proximity
Moderate travel required
Must complete billing and reimbursement training within 30 days of hire or each refresher year date (1/31). The passing score for completion is 80%.
Job: Conifer Health Solutions
Primary Location: Frisco, Texas
Job Type: Full-time
Shift Type: Days
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.
Internal Number: 2005004482
About Conifer Health Solutions
“Tenet Healthcare Corporation is a diversified healthcare services company with 115,000 employees united around a common mission: to help people live happier, healthier lives. Through its subsidiaries, partnerships and joint ventures, including United Surgical Partners International, the Company operates general acute care and specialty hospitals, ambulatory surgery centers, urgent care centers and other outpatient facilities. Tenet's Conifer Health Solutions subsidiary provides technology-enabled performance improvement and health management solutions to hospitals, health systems, integrated delivery networks, physician groups, self-insured organizations and health plans.