As a part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions nationwide. We help our clients strengthen their financial and clinical performance, serve their communities and succeed at the business of healthcare. Conifer Health helps organizations transition from volume to value-based care, enhance the consumer and patient healthcare experience and improve quality, cost and access to healthcare. Are you ready to be part of our solutions? Welcome to the company that gives you the resources and incentives to redefine healthcare services, with a competitive benefits package and leadership to take your career to the next step!

JOB SUMMARY

Develop, maintain and enhance relationships with assigned payers and act as the primary resource to establish, oversee, and maintain positive relationships by assisting with or responding to complex issues regarding policies and procedures, plan design, contract language, service, claims or compensation issues. Acts as a liaison between internal departments of Conifer, the Client and the Payer community. Responsible ultimately for account resolution and cash acceleration.

ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned.

• Collaborate with payers and negotiators as needed to ensure compliance with contract policies and parameters. Ensure compliance with state and federal laws and regulations. Ability to articulate contract provisions as well as state/fed legislation to the payers to drive resolution.
• Optimizes interactions with assigned providers and internal business partners to establish and maintain productive, professional relationships that ultimately resolve accounts. Manages the development of agendas, validates materials, and facilitates external payer meetings regularly.
• Maintains a thorough understanding of health insurance and government programs, where necessary.
• Coordinate efforts with stakeholders to drive changes in auto adjudication, aging and cycle time. Follow up with cross functional teams to ensure we are following through with implemented changes.
• Works with A/R supervisors to identify department training needs for system education, industry updates and changes in collection processes and protocols. Provide guidance and training to support teams

Conifer requires its candidates, as applicable and as permitted by law, to obtain and provide confirmation of all required vaccinations and screenings prior to the start of employment. This may include, but is not limited to, the COVID-19 vaccination, influenza vaccination, and/or any future required vaccines and screenings.

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.

• Advanced knowledge of healthcare A/R
• Excellent working knowledge of Patient Financial Services operations with specific focus on Inpatient and Outpatient Managed Care and Commercial payers (i.e., Medicare regulations and compliance; HIPAA)
• Proficient in Microsoft Office (Word and Excel)
• Advanced writing skills
• Ability to provide advanced customer service
• Ability to plan and implement process improvements
• Ability to train and coach staff
• Ability to multi-task
• Strong leadership and organizational skills
• Proficient in building a strong team to meet performance goals
• Very good written and verbal communication skills
• Strong interpersonal skills
• Strong technical skills, including PC and MS Office Suite knowledge

EDUCATION / EXPERIENCE

Include minimum education, technical training, and/or experience preferred to perform the job.

• 4 year college degree in Healthcare Administration, Business or related area or equivalent experience. MBA/CPA preferred
• 5 – 10 years experience in Healthcare Administration or Business Office
• 2 – 3 years supervisory experience

CERTIFICATES, LICENSES, REGISTRATIONS

• HFMA-Patient Accounts or Hospital Accounting Certification encouraged

PHYSICAL DEMANDS

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

WORK ENVIRONMENT

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.

• Call Center environment with multiple workstations in close proximity

Employment practices will not be influenced or affected by an applicant’s or employee’s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.