• Managing client relations • Employee health duties • Occupational health program activities • Revenue cycle activities • Client account reconciliation • Client management meetings • Maintaining client issues list • Understanding various client/vendor processes for account follow-up • Proposing relevant programs • Reviewing reported client or account issues • Working proactively with clients, departments, and teams for timely resolution • Assisting with case management under FA worker’s compensation program • New hire and transfer physicals, EAP, random drug testing program, and annual employee health surveillance • Maintain the client base for Franciscan Working Well • Develop positive client relationships and market programs service • Establishing efficient revenue cycle and monitoring aging reports • Submitting CMV Driver examination reports • Maintaining follow-up procedures and working relationships with several responsible areas • Managing assigned vendor inventory • Performing account audits and periodic audits of contractual adjustments • Processing and following up on work denials and adjustments • Reviewing daily Recon reports

Role Description The Employee/Occ Health Representative is responsible for managing client relations and a variety of employee health duties, including: - Managing various occupational health program activities - Revenue cycle activities - Client account reconciliation - Client management meetings - Maintaining a client issues list - Understanding various client/vendor processes for account follow-up - Proposing relevant programs This position reviews reported client or account issues and works proactively with appropriate clients, Hospital Departments/vendor, FAIS, and ABO/CBO team members for timely resolution of the issue. Qualifications - Preferred Associate's Degree - Required High School Diploma/GED - 1 year Patient Accounting Preferred - Personal Financial Specialist (PFS) Requirements - Ensures compliance with all state and federal billing regulations; reports any suspected compliance issues to management. - Executes client specific process flows and adheres to timelines for various follow-up processes. - Maintains a client issues list for review and resolution with the appropriate Hospital departments. - Assists with case management under FA worker’s compensation program, new hire and transfer physicals, EAP, random drug testing program, and the annual employee health surveillance. - Maintains the client base for Franciscan Working Well and develops positive client relationships, marketing the program's service. - Performs activities relevant to establishing an efficient revenue cycle in addition to monitoring aging reports in conjunction with billing service. - Submits CMV Driver examination reports on the National Registry of Certified Medical Examiners website by fulfilling the duties of a medical examiner’s administrative assistant. - Maintains follow-up procedures and working relationships with areas responsible for the information including the Medical Records Department, Patient Access, or physicians. - Manages assigned vendor inventory, ensuring accuracy and compliance with contractual agreements. - Performs at least 10 account audits monthly for each specific line of vendor business. - Performs periodic audits of contractual adjustments from vendor staff. - Processes and follows up on work denials and adjustments submitted by the vendor. - Reviews daily Recon reports. - Cash Posting experience. Benefits Franciscan provides eligible employees with comprehensive benefit offerings. Find an overview on the benefit section of our career site, jobs.franciscanhealth.org.

• Complete investigations and make decisions and recommendations for claims with varying levels of severity and complexity across multiple jurisdictions. • Establish and update estimates to reflect exposure. • Develop and employ creative resolution strategies. • Implement proactive action plans and resolution strategies created in partnership with customers, fronting carriers, and stakeholders. • Communicate claim status efficiently and effectively with all parties, which may include business partners, injured employees, medical providers, and legal counsel while utilizing various digital channels, actively listening, and processing information. • Maintain open lines of communication and anticipates touchpoints to engage the customer so they are kept apprised of any changes on each claim and to discuss strategies. • Provide quality customer service, ensure file quality, timely coverage analysis, and communication with the customer based on application of policy information to facts or allegations of each case. • Fulfills specific service commitments made to certain accounts, as outlined in Special Account Communication (SAC) instructions, as well as adhering to fronting carrier handling requirements. • Actively engage in the identification, selection and direction of appropriate internal and/or external resources for specific activities required to effectively resolve claims. • Maintain and document claim file activities in accordance with established procedures and customer/fronting carrier expectations. • To perform the essential functions of the job, acquisition and maintenance of Insurance License(s) may be required to comply with state and Travelers requirements.

• Execute core credentialing and provider data management functions to ensure compliance with regulatory and organizational standards • Support the full credentialing lifecycle, including initial credentialing, re-credentialing, and privileging of providers • Maintain accurate records and deliver high-quality service to internal and external stakeholders • Perform delegated credentialing activities in accordance with established policies and procedures • Process provider applications and re-applications, including review for completeness and system data entry • Verify provider credentials, maintain accurate provider profiles within credentialing systems • Prepare credentialing files and documentation for committee review • Manage communications in the Credentialing and Verifications inbox, ensuring timely responses • Support Medicaid provider enrollment activities and maintain accurate enrollment records • Conduct routine audits and assist with departmental projects and process improvement initiatives