Credit Resolution Representative - Remote
Tenet Healthcare
- USA
- $15.80-23.70 per hour
- Permanent
- Full-time
- 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.
- Entry level understanding of hospital billing form requirements (UB04 and HCFA 1500)
- Entry level knowledge of ACE/PBAR/STAR/Meditech or EPIC preferred
- Entry level knowledge of ICD-10, HCPCS/CPT coding and medical terminology
- Entry level writing skills
- Contract Interpretation skills greatly preferred
- 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, preferred.
- 1 - 3 years' experience in a hospital business environment performing billing and/or follow-up functions, preferred.
- Ability to sit and work at a computer terminal for extended periods of time
- Call Center environment with multiple workstations in close proximity
- Some positions may be eligible for Telecommuting based off Business need or position function. If eligible, all Telecommuting guidelines must be adhered to at all times.
- Pay: $15.80-$23.70 per hour.
- Conifer observed holidays receive time and a half.
- 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.