Job Description

The primary purpose of the REP, PHYS SVC AR II team is to pursue reimbursement of services rendered and achieve accounts receivable resolution. This team works through open accounts receivables (denials and delinquent accounts) by actively calling payer organizations or utilizing web-based connectivity. Team members manage accounts by utilizing the IDX Paperless Collection System and Epic follow-up work queues.

The core responsibilities of a REP, PHYS SVC AR II is to perform collection follow-up steps with insurance carriers and/or patients regarding open accounts receivable and/or delinquent accounts to result in maximum cash collections for our clients. Specific tasks include resolving insurance carrier denials, appealing claims, contacting carriers on open accounts and responding to insurance carrier correspondence and/or inquiries. This position holds additional duties with respect to research and possible exposure to multiple practice management systems.

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Contact insurance carriers through website, email or telephone to resolve outstanding accounts
• Analyze and resolve moderately complex insurance denials
• Appeal and/or resubmit unresolved invoices to insurance carriers
• Research and respond to insurance correspondence
• Update registration information, post denial codes and adjustments in practice management systems
• Research and obtain required documents to resolve misdirected payment issues
• May provide internal coverage for Customer Service calls
• Others may be assigned.

EDUCATION / EXPERIENCE

• High school diploma or equivalent
• 1-2 years experience in healthcare collections and/or healthcare related field
• Previous experience with medical billing systems preferred: IDX or Epic experience a plus
• Knowledge of CPT, ICD-9 and HCPCS codes
• Understanding of government payers and other commercial/managed care carrier rules and processes in a professional billing environment
• Attention to detail with the ability to identify/resolve problems and document the outcome
• Strong written and verbal communication skills
• Solid analytical and problem solving skills to recognize trends
• Ability to multi-task and work independently
• Moderate skill with Microsoft Office applications: Word, Excel
• Initiative to learn new tasks and the ability to apply acquired knowledge to future duties

Company Description

Conifer Health Solutions is a healthcare services company partnering with more than 800 clients to strengthen their financial and clinical performance. Conifer Health helps organizations transition from volume to value-based care, enhance the consumer and patient healthcare experience and improve quality, access to healthcare and control costs. Conifer Health manages more than 24 million unique patient interactions, and $30 billion in net patient revenue and $21.5 billion in medically managed spend. Conifer Health also provides technology and health management services to support care management for 5.7 million lives. For more information, visit coniferhealth.com or follow @coniferhealth on Twitter.