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Company

Conifer Health Solutions · 7 hours ago

Credit Resolution Representative

Frisco, TX

Full-time

Remote

Entry Level

$17.20/hr - $25.70/hr

1+ years exp

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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.

Qualification

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Hospital billing formsICD-10 codingManaged Care contractsACE/PBAR/STAR/MeditechHCPCS/CPT codingContract InterpretationMedical terminologyGov’t Medicare regulationsState Medicaid programs

Required

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)

Ability to sit and work at a computer terminal for extended periods of time

Preferred

Entry level knowledge of ACE/PBAR/STAR/Meditech or EPIC preferred

Contract Interpretation skills greatly preferred

High School Diploma or equivalent experience, preferred

1 – 3 years’ experience in a hospital business environment performing billing and/or follow-up functions, 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.