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!
JOB SUMMARY 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.
â�¢ Ensures that all Mail is processed, appropriately, ensures certified and express mail are prioritized for daily production. â�¢ Ensures compliance with state and federal law regulations for Managed Care and other third party payors. â�¢ Develops or approves recommendations to change policies and procedures; ensures timely and accurate implementation. â�¢ Implements strategies for improving the TAT in processing mail, EDI reports, and DCM/CRC print. â�¢ 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. â�¢ Ensures DCM/CRC CIDâ��s are worked and completed in a timely and efficient manner, meeting production goals of zero days by end of week. â�¢ Ensures hard copy billing is processed, efficiently and timely meeting production goals of 1 day unprocessed by end of week. â�¢ Completes QA on all areas of responsibility, documents and provides employee training as required. â�¢ Provides back up supervision for billing supervisor as needed for meetings, PTO, coverage.
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.
â�¢ Intermediate Microsoft Office (Word, Excel) â�¢ Intermediate knowledge of ICD9/CPT4 codes and payor requirements â�¢ Working knowledge of National Uniformed Billing Code, CPT/HCPC, ICD-9 and UB-04 â�¢ Intermediate knowledge of HIPAA guidelines â�¢ Intermediate writing skills â�¢ Ability to multi-task â�¢ Strong leadership and organizational skills EDUCATION / EXPERIENCE Include minimum education, technical training, and/or experience required to perform the job.
â�¢ 4 year college degree in Business or Healthcare Administration preferred â�¢ 3 -5 years 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 â�¢ Experience as a Patient Accounts Supervisor preferred â�¢ Experience with business process redesign desirable
PHYSICAL DEMANDS 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.
â�¢ Must be able to work in sitting position, use computer and answer telephone â�¢ Ability to travel â�¢ Includes ability to walk through hospital-based departments across broad campus settings, including Emergency Department environments
WORK ENVIRONMENT 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.
â�¢ Call Center environment with multiple workstations in close proximity â�¢ Moderate travel required
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: 2105001179
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.