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!
The primary purpose of the REP, PHYS SVC AR II team is to pursue reimbursement of services rendered and achieve accounts receivable resolution. This team works through open accounts receivables (denials and delinquent accounts) by actively calling payer organizations or utilizing web-based connectivity. Team members manage accounts by utilizing the IDX Paperless Collection System and Epic follow-up work queues.
The core responsibilities of a REP, PHYS SVC AR II is to perform collection follow-up steps with insurance carriers and/or patients regarding open accounts receivable and/or delinquent accounts to result in maximum cash collections for our clients. Specific tasks include resolving insurance carrier denials, appealing claims, contacting carriers on open accounts and responding to insurance carrier correspondence and/or inquiries. This position holds additional duties with respect to research and possible exposure to multiple practice management systems.
ESSENTIAL DUTIES AND RESPONSIBILITIES
Contact insurance carriers through website, email or telephone to resolve outstanding accounts
Analyze and resolve moderately complex insurance denials
Appeal and/or resubmit unresolved invoices to insurance carriers
Research and respond to insurance correspondence
Update registration information, post denial codes and adjustments in practice management systems
Research and obtain required documents to resolve misdirected payment issues
May provide internal coverage for Customer Service calls
Others may be assigned.
EDUCATION / EXPERIENCE
High school diploma or equivalent
1-2 years experience in healthcare collections and/or healthcare related field
Previous experience with medical billing systems preferred: IDX or Epic experience a plus
Knowledge of CPT, ICD-9 and HCPCS codes
Understanding of government payers and other commercial/managed care carrier rules and processes in a professional billing environment
Attention to detail with the ability to identify/resolve problems and document the outcome
Strong written and verbal communication skills
Solid analytical and problem solving skills to recognize trends
Ability to multi-task and work independently
Moderate skill with Microsoft Office applications: Word, Excel
Initiative to learn new tasks and the ability to apply acquired knowledge to future duties
Job: Conifer Health Solutions
Primary Location: Tinley Park, Illinois
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: 2005044620
About Conifer Health Solutions
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.