Pre-Legal Specialist

Description

Conifer Health Solutions is a leading healthcare business process management services provider working to improve operational performance for more than 600 clients so they can support financial improvement, enhance the patient experience, and drive value-based performance. Through our revenue cycle management, patient communications, and value-based care solutions, we empower healthcare decision makers—hospitals, health systems, physicians, self-insured employers, and payers—to better connect every point of care and wellness management. 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 (incl, titles) Patient Acct Reps, Sr Patient Acct Reps, Lead Patient Acct Reps, and Patient Acct Supervisors

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

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

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+ years’ experience in medical billing, collections, appeals, legal department and/or contract interpretation

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: $20.51 - $30.77 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.