Tenet, through its subsidiaries, owns and operates acute care hospitals and numerous related health care services. Our mission is to be recognized for our commitment to our people and partners who provide quality, innovative care to the patients we serve in our communities. It's a spirit you can experience first-hand and it's a philosophy that can enhance your own approach to health care and your career goals.
At Conifer Health Solutions, we offer the strength and stability of Tenet Healthcare, a Fortune 500 company, with the ingenuity and energy of a healthcare independent. We are a healthcare solutions company born from the healthcare industry. We take care of hospital business, so hospitals can focus on caring for patients. Ready to be part of our solutions? Welcome to a company that gives you the resources and incentives to redefine healthcare services, with the benefits and leadership to take your career to the next step!
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&P's, 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.
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
ome college coursework in business administration or accounting preferred
2 - 4 years experience
in a hospital business environment performing billing and/or follow-up functions
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
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
238-Conifer - Anaheim - CA
8 Hour Day
Shift begin time
Shift end time
Tenet Healthcare - 2 years ago