Founded in 2008, Conifer Health Solutions is an independent healthcare services company that specializes in managed services for health systems. Conifer Health Solutions employs th
Denial Management Representative
Location
United States
Posted
45 days ago
Salary
$16 - $24 / hour
Seniority
Mid Level
No structured requirement data.
Job Description
Denial Management Representative
Conifer Health Solutions
Role Description The Patient Account Representative is responsible for working accounts to ensure they are resolved in a timely manner. This candidate should have a solid understanding of the Revenue Cycle as it relates to the entire life of a patient account from creation to payment. - Effectively follow-up on claim submission and remittance review for insurance collections. - Create and pursue disputed balances from both government and non-government entities. - Work as part of a dynamic team and adapt to changing work assignments. - Work independently and closely with management and team members to resolve accounts. - Interact professionally with insurance plans, patients, physicians, attorneys, and team members. - Utilize basic computer skills to navigate various system applications. - Access payer websites and discern pertinent data to resolve accounts. - Document clear and concise notes in the patient accounting system. - Maintain department daily productivity goals while meeting quality standards. - Identify and communicate issues related to system access, payor behavior, and account workflow inconsistencies. - Provide support for team members that may be absent or backlogged. Qualifications - Thorough understanding of the revenue cycle process. - Intermediate skill in Microsoft Office (Word, Excel). - Ability to learn hospital systems quickly and fluently. - Good oral and written communication skills. - Strong interpersonal skills. - Above average analytical and critical thinking skills. - Ability to make sound decisions. - Understanding of Commercial, Managed Care, Medicare, and Medicaid collections. - Familiarity with terms such as HMO, PPO, IPA, and Capitation. - Intermediate understanding of EOB and hospital billing form requirements. - Ability to problem solve, prioritize duties, and follow through with assigned tasks. Requirements - High School diploma or equivalent; some college coursework in business administration or accounting preferred. - 1-4 years medical claims and/or hospital collections experience. - Minimum typing requirement of 45 wpm. Benefits - Medical, dental, vision, disability, and life insurance. - Paid time off (vacation & sick leave) – minimum of 12 days per year. - 401k with up to 6% employer match. - 10 paid holidays per year. - Health savings accounts, healthcare & dependent flexible spending accounts. - Employee Assistance program and Employee discount program. - Voluntary benefits including pet insurance, legal insurance, and more. - Paid leave in accordance with Colorado’s Healthy Families and Workplaces Act for Colorado employees.
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