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

Responsible for answering incoming calls from providers, health plan and members as they relate to eligibility, benefits, claims, coverage and authorization of services. This position supports multiple lines of business and will also problem-solve and explain programs and procedures to callers and will answer/address claim payment questions with providers.

ESSENTIAL DUTIES AND RESPONSIBILITIES

Include the following. Others may be assigned.

• Answering incoming phone calls via ACD phone system
• Entering of telephonic referrals
• Provide eligibility, benefits, claim and referral status depending on the queue on which they serve
• Retrieve Voice Mails
• Assist in resolving issues for providers as they relate to claims, authorization and eligibility inquiries
• Serves as resource to CSRI
• Special projects as assigned
• Able and willing to step in, in the absence of the lead and or supervisor to lead the team.

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 activity. 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.

• A strong sense of responsibility for providing a great customer experience
• Detail-oriented and highly-organized
• Leadership skills
• Excellent verbal and written communication skills.
• Excellent organization skills with ability to handle multiple tasks and prioritize work.
• Knowledge of CPT, ICD-10, HCPCS codes, HCFA1500 and UB04 billing forms.

EDUCATION / EXPERIENCE

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

• 2-3 years of customer service experience in a call center and or health care environment preferred
• High school degree or equivalent required, Bachelor degree preferred

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.

• Must be able to work in sitting position, use computer and answer telephone

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.

• Office Work Environment

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.