Hospital Billing Representative - Boca Raton, FL

Description

As a part of the Tenet and Catholic Health Initiatives family, 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 communication s, and value-based care solutions, we empower healthcare decision makershospitals, health systems, physicians, self-insured employers, and payersto 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!


Conifer Health Solutions is currently hiring for a Medicaid A/R Representative.


JOB SUMMARY
Responsible for processing Medicaid claims for assigned hospitals and for follow-up on all billed claims to ensure final accurate disposition by Medicaid.

ESSENTIAL DUTIES AND RESPONSIBILITIES
Include the following. Others may be assigned.
When performing billing functions A/R Rep corrects claims with errors by referencing account notes, manual change to claim sharepoint site, P&Ps, and or process job aides. Or by referring claim using the appropriate QS activity code to route to appropriate facility representative for action.
Will maintain assigned desks and/or control ID worklist by keeping current on assigned follow-up dates via workflow. Works remittance advice from Medicaid ensuring accuracy of payments; changes account financial class as appropriate; corrects account balance in accordance with Medicaid disposition; follows up on denied claims.
Updates system (notes and memos posted immediately) with appropriate changes; maintains quality control on all accounts for correct activity codes, result/action codes and payor and financial class updates
Performs payment/refund follow-up activities on patient accounts as assigned, through telephone contact or by means of online tools.


Qualifications
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.
Intermediate understanding of hospital billing form requirements (UB04 and CMS 1500)
Intermediate understanding of CPT, HCPCS and ICD-9 coding regulations and guidelines
Understanding of Medicaid billing and collection guidelines preferred
Entry level MS Word
Intermediate MS Excel
Ability to provide excellent customer service
Knowledge of hospital information systems a plus

EDUCATION / EXPERIENCE
Include minimum education, technical training, and/or experience preferred to perform the job.
High School Diploma or equivalent required; some college coursework in business administration or accounting preferred
2 - 4 years experience in a hospital business environment performing billing and/or follow-up functions
PHYSICAL DEMANDS
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Ability to sit and work at a computer terminal for extended periods of time


WORK ENVIRONMENT
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Office/Team Work Environment



Office Environment

Our purpose at Conifer Health Solutions is to provide the foundation for better health the health of our clients, the communities in which we work and serve, and most importantly each other. That is why our new Frisco Texas campus will be tobacco-free, meaning there will be no designated smoking areas or use of any tobacco, nicotine or smoking products on the premises. We aim to move into the new building in the first few months of 2014.
About Tenet Healthsystem Medical, Inc
The work we do is important. The value we add is significant. At Conifer Health Solutions, we provide hospitals with the expertise, insight and technology to address the financial challenges that ultimately impact patient care in our communities. Our solutions outperform in-house revenue management and call centers, as well as technology and consulting partners. By focusing on the financial and patient communication aspects of healthcare, we enable healthcare providers to focus on what they do best — providing exceptional patient care.