[Remote] Credit Resolution Representative - Remote

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

Company H1B Sponsorship