Physician Services Refunds Representative

Description

JOB SUMMARY

The primary purpose of the REP, PHYS SVC REFUNDS is to review all credit balances that are created on a patient’s account to determine whether the credit is a true refund, or the appropriate actions needed to remove the credit from the patient’s account within timely manner from identification and in accordance with CMS rules and regulations, provider contracts and/or Conifer policies.

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Examine the credit balances for one or more clients.
• Run monthly credit balance reports.
• Research, analyze, and successfully resolve a credit balance to completion.
• Communicate with insurance companies and occasionally patients.
• Utilization of insurance websites
• Comply with Cash Applications department policies and procedures.
• Maintain productivity and quality standards set by the Refunds Manager
• Meet deadlines set by the department, client contracts and/or Conifer organization.
• Others may be assigned.

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.

EDUCATION / EXPERIENCE

• High School Diploma or General Education Degree (GED) required.
• Intermediate skill level using Microsoft applications: Word, Excel, Outlook, Teams
• EPIC and GE Centricity/IDX/Athena experience helpful
• Basic knowledge of government insurances (CMS, Medicare, Medicaid, Tricare)
• Basic knowledge of national insurances (Blue Cross, UHC, Aetna, Cigna, etc.)
• Must have effective oral and written communication skills.
• Ability to operate effectively as a team member and be able to manage time constraints daily/weekly/monthly.
• Initiative to learn new tasks and the ability to apply acquired knowledge to future duties.
• Medical Billing/Revenue Cycle experience helpful
• Cash Posting experience helpful.

POSITION COMPETENCIES:

• Builds Team Relationships - Invites others to share opinions. Partners with employees in other departments. Actively seeks ways to help team members.
• Communicates Effectively – Expresses ideas clearly and succinctly with small or large audiences. Listens attentively to speaker’s message without interruption. Tailors writing to audience using correct grammar and spelling.
• Compliance with Laws, Policies and Procedures - Adheres to company handbook and policies. Demonstrates behavior consistent with Code of Conduct. Adheres to compliance program and guidelines.
• Develops Self - Seeks opportunities for continuous learning. Modifies behavior in response to feedback. Knows personal strengths and weaknesses and demonstrates ownership for personal development.
• Displays Adaptability – Performs well in high pressure or stressful situations. Works effectively when direction is unclear or rapidly changing. Demonstrates persistence in the face of obstacles.
• Drives for Results - Delivers high quality work and attains results. Demonstrates personal drive and pushes self and others for results and quality work. Response appropriately to urgent situations.
• Focus on the Customer/Client – Ensures that clients have a positive experience. Responds to clients in a timely manner. Demonstrates tact and empathy when responding to clients.
• Respects Others - Displays sensitivity to the needs and concerns of others. Interacts with others in an open, non-threatening manner.
• Shows Reliability – Takes personal responsibility for actions and decisions. Consistently works assigned schedule. Acts responsibly and can be counted on to accomplish goals successfully.

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!

Compensation and Benefit Information

Compensation

• Pay: $14.50 - $21.80 per hour. Compensation depends on location, qualifications, and experience.
• Position may be eligible for a signing bonus for qualified new hires, subject to employment status.
• Conifer observed holidays receive time and a half.

Benefits

Conifer offers the following benefits, subject to employment status:

• Medical, dental, vision, disability, and life insurance
• Paid time off (vacation & sick leave) – min of 12 days per year, accrue at a rate of approximately 1.84 hours per 40 hours worked.
• 401k with up to 6% employer match
• 10 paid holidays per year
• Health savings accounts, healthcare & dependent flexible spending accounts
• Employee Assistance program, Employee discount program
• Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, AD&D, auto & home insurance.
• For Colorado employees, Conifer offers paid leave in accordance with Colorado’s Healthy Families and Workplaces Act.