Patient Account Lead Representative - Remote

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 assistance, coaching and training to staff members, including new hires. They support and assist the Team, the Supervisor and Management with complex inventory and issue resolution. Responsible for all aspects of the billing, follow up and collection activity for payers that are Supplemental to Medicare. May maintain a large dollar inventory desk or complex accounts as well as serve as just-in-time staffing, working inventory for team members that may be absent or backlogged. May assist in special projects as assigned my management, including acting as a point of contact for internal operational questions.

ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned.

• Responsible for all aspects of insurance follow up and collections, including making telephone calls, accessing payer websites. May maintain a large dollar inventory desk as well as serve as just-in-time staffing, working inventory for team members that may be absent or backlogged. Effectively resolve complex or aged inventory, including payment research, payment recoups with minimal or no assistance necessary. Accurately and thoroughly document the pertinent collection activity performed. Review the account information and necessary system applications to determine the next appropriate work activity. Verify claims adjudication utilizing appropriate resources and applications. Initiate telephone or letter contact to patients to obtain additional information as needed. Perform appropriate billing functions, including manual re-bills as well as electronic submission to payers. Edit claims to meet and satisfy billing compliance guidelines for electronic submission. Manage and maintain desk inventory, complete reports, and resolve high priority and aged inventory. Proactively identify issues or trending and provide suggestions for resolution.
• Provide assistance, coaching and training to staff members, including new hires. Provide enhanced training and assist staff with techniques to increase production, quality and collections. Participate in the new hire peer interviewing process. Assist in special projects assigned by management.
• Participate and attend meetings, training seminars and in-services to develop job knowledge. Attend various conference calls, webinars or advanced training to provide assistance to the team members. Respond timely to emails and telephone messages from the staff, management and the client. Effectively communicate issues to management, including payer, system or escalated account issues as well as develop solutions.

FINANCIAL RESPONSIBILITY (specify Revenue/Budget/Expense): $2.5 million R&D Budget

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 activity. 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.

• Very good written and verbal communication skills
• Strong interpersonal skills
• Advanced technical skills including PC and MS Outlook
• Advanced knowledge of UB-04 and Explanation of Benefits (EOB) interpretation
• Advanced knowledge of CPT and ICD-9 codes
• Advanced knowledge of insurance billing, collections and insurance terminology

EDUCATION / EXPERIENCE

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

• High school diploma or equivalent education
• 3-6 years experience in Medical/Hospital Insurance related collections

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.

• Office/Team Work Environment