Note: The job is a remote job and is open to candidates in USA. Conifer Health Solutions is a leading healthcare company with over 30 years of industry expertise. They are seeking a Credit Resolution Representative responsible for performing refunds and credit analyses within the Hospital Revenue Cycle Management team, ensuring appropriate actions are taken to resolve credit balances.
Responsibilities
- Performs refund and credit analyses, audit and reimbursement functions for all Managed Care, Commercial, Medicare, Medicaid, Self-pay and third party payors for all patient accounts
- Determines if credit balance is an over contractual, late charges applied, overpayment etc. to ensure appropriate actions are taken to resolve
- Performs Quarterly reviews for Medicare and Medicaid (based on state guidelines) and submits to client for approval, signature and submission
- Manage and maintain desk inventory, complete reports, and resolve high priority and aged inventory
- Accurately and thoroughly documents the pertinent credit balance review activity performed
- Communicate issues to management, including payer, system or escalated account issues
- Handle correspondence received from payers and patients requesting refunds
- Respond timely to emails and telephone messages as appropriate
- Participate and attend meetings, training seminars and in-services to develop job knowledge
- Other duties as assigned by Management
Skills
- Entry level understanding of hospital billing form requirements (UB04 and HCFA 1500)
- Entry level knowledge of ICD-10, HCPCS/CPT coding and medical terminology
- Entry level writing skills
- Understanding and interpretation of Managed Care contracts
- Understanding of Gov't Medicare and multiple state Medicaid programs payor regulations (if Gov't team)
- High School Diploma or equivalent experience
- 1 – 3 years' experience in a hospital business environment performing billing and/or follow-up functions
- Ability to sit and work at a computer terminal for extended periods of time
- Entry level knowledge of ACE/PBAR/STAR/Meditech or EPIC
- Contract Interpretation skills greatly preferred
Benefits
- 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.
Company Overview
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