Credit Resolution Representative - Remote

Conifer Health Solutions

13d•$17 - $26•Remote

About The Position

Responsible for performing the refunds and credit analyses functions within the Hospital Revenue Cycle Management team. ESSENTIAL DUTIES AND RESPONSIBILITIES Include the following. Others may be assigned. 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.

Requirements

Entry level understanding of hospital billing form requirements (UB04 and HCFA 1500)
Entry level knowledge of ACE/PBAR/STAR/Meditech or EPIC preferred
Entry level knowledge of ICD-10, HCPCS/CPT coding and medical terminology
Entry level writing skills
Contract Interpretation skills greatly preferred
Understanding and interpretation of Managed Care contracts
Understanding of Gov’t Medicare and multiple state Medicaid programs payor regulations (if Gov’t team)
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.
High School Diploma or equivalent experience, preferred.
1 – 3 years’ experience in a hospital business environment performing billing and/or follow-up functions, preferred.
Ability to sit and work at a computer terminal for extended periods of time

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.
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.
Participate and attend meetings, training seminars and in-services to develop job knowledge.
Other duties as assigned by Management.

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.

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