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 providing direct support to AR/Disputes operations team, client, Conifer One team, and subcontracted external legal resources engaged in the collection and recovery of complex underpaid claims.

ESSENTIAL DUTIES AND RESPONSIBILITIES

Include the following. Others may be assigned.

• In depth knowledge of applicable contracts. Ensure compliance with state and federal laws and regulations. Maintains a thorough understanding of health insurance and government programs, where necessary.
• Acts as liaison between the Business Office, Legal Department, Client and outside counsel regarding outstanding litigations
• Is a trusted advisor to internal and external customers
• Prepare agenda and assist with facilitation of Client calls (weekly)
• Prepares Dispute packages for assignment to law firms per Client instructions
• Hold status update calls (bi-weekly/monthly) with law firms for assignment updates and inventory disposition
• Works required reports (daily, weekly, monthly) to ensure legal payer issues are referred in a timely manner
• Comfortable reviewing large data sets. Must possess ability to utilize data inferences to come up with process optimization and prioritization of tasks
• Identify process improvement opportunities and assist with implementation

SUPERVISORY RESPONSIBILITIES

If direct report positions are listed below, the following responsibilities will be performed 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.

• No. Direct Reports: Patient Acct Reps, Sr Patient Acct Reps, Lead Patient Acct Reps, and Patient Acct Supervisors

Conifer requires its candidates, as applicable and as permitted by law, to obtain and provide confirmation of all required vaccinations and screenings prior to the start of employment. This may include, but is not limited to, the COVID-19 vaccination, influenza vaccination, and/or any future required vaccines and screenings.

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.

• Advanced knowledge of healthcare A/R
• Excellent working knowledge of Patient Financial Services operations with specific focus on Inpatient and Outpatient Managed Care and Commercial payors (i.e., Medicare regulations and compliance; HIPAA)
• Proficient in Microsoft Office (Word and Excel)
• Ability to provide advanced customer service
• Ability to multi-task
• Strong time management and organizational skills
• Ability to research and work independently
• Ability to communicate in a professional manner
• Good written and verbal communication skills
• Strong interpersonal skills
• Strong technical skills, including PC and MS Office Suite knowledge

EDUCATION / EXPERIENCE

Include minimum education, technical training, and/or experience preferred to perform the job.

• High school diploma or equivalent
• Associate/Bachelor Degree preferred
• Advanced excel skills is a plus
• 5+ yearsâ�� experience in medical billing, collections, appeals, legal department and/or contract interpretation

Employment practices will not be influenced or affected by an applicant�s or employee�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.