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 all payment application functions within the Reimbursement and Cash Management team in the National Insurance Center (NIC).
Develops, coaches, monitors, and/or mentors staff.Conducts performance evaluations; schedules and approves overtime and takes disciplinary action as necessary.Assist in the day-to-day operations by serving as a resource to staff; monitors refund activity and make changes as needed to meet unit demands.Tracks productivity of all Credit Analyst and/or Credit Resolution Reps.
Run queries and create reports on a routine basis to identify credit balance accounts and distributes to the staff. Reports and provides trends and patterns in payer overpayments.
Interacts with internal/external customers and/or vendors for resolution of new credit balance accounts and responsible for reviewing and working accounts. Work directly with the BPO credit resolution team to resolve issues
Performs refund and debit adjustment approvals while auditing the reimbursement functions for the adjudication system for contracts in place with Managed Care, Commercial, and third party payors on patient accounts.
Ensures compliance with Tenet Standard Operating Procedures.Interprets and ensures the consistent application of Tenet policies in regard to patient, commercial and government payersï¿½ refunds
Provide effective one-on-one follow-up/practical training to ensure effective assimilation of formal training ideas and methods.
Develops or approves recommendations to change systems, policies and procedures; ensures timely and accurate implementation.
Other duties as assigned by Management
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 writing skills
Intermediate Microsoft Office (Word, Excel)
Ability to multi-task
Strong leadership and organizational skills
Intermediate knowledge of Healthcare A/R
Advanced knowledge of ACE/PBAR and/or workflow processes
Ability to provide advanced customer service
Ability to train and coach staff
Proficiency in contract payer methodology, managed care and commercial insurance.
EDUCATION / EXPERIENCE
Include minimum education, technical training, and/or experience preferred to perform the job.
4 year college degree in Business or Healthcare Administration preferred
3-5 years experience providing leadership and management direction related to collections and follow-up of Managed Care and Commercial processes within a multi-facility environment
3-5 years experience in Healthcare Administration or Business Office, specifically in Managed care.
1-2 years Supervisory experience.
Experience as a Patient Accounts Supervisor is 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.
Ability to sit and work at a computer terminal for extended periods of time
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
Provide any additional information or requirements that would be helpful to someone trying to understand the nature, scope or purpose of this position.
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: 2005033393
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.