Together, The Opportunities Ahead Are Unlimited
Liaison between facility and Conifer operations for multiple facilities. Executive resource for Conifer for client local leadership. Focused on growing on-site relationships via client revenue, reputation and image by service, and performance for the client. Critical responsibilities include: (a) engaging key client executive management to understand needs (b) working with Conifer internal business colleagues to assess, develop, and recommend service solutions; (c) educating the client, monitor performance objectives, prepare for and conduct monthly meetings, (d) report with peer-level operations personnel underlying metrics, and improvement opportunities to ensure it meets/exceeds the expected levels of performance, (e) ensuring the contractual expectations are met and exceeded, (f) managing the client financials based upon business objectives and service level agreements, (g) managing the account P&L, (h) meeting revenue and profit goals, (i) setting strategy that continues to long-term strategy of overall client account. Maintains active and involved, broad client executive relationships (CFO, CEO, CIO, COO and CMO), advises clients in a proactive manner the current performance and next areas of mutual opportunity. Provides oversight and Management to various Conifer departments onsite within the Client Site.
Responsible for screening self-pay patients at hospital bedside for eligibility in various governmental and non-governmental programs or insurance exchange. Responsible for identifying all sources of potential payors including auto insurance, Workers’ Compensation, commercial insurance, private insurance, TPL, etc. to route account appropriately in the Patient Accounting environment. Also responsible for obtaining and completing the Confidential Financial Statement form and assisting patients in the process of applying for any benefits for which they may be eligible.
Responsible for all aspects of billing, follow up and collection activity. Two plus years acute hospital revenue cycle and accounts receivable experience required. This position will support a MediTech facility working on ACE, experience is a plus. Heavy insurance follow up, not just benefit verification.
Responsible for validating dispute reasons following Explanation of Benefits (EOB) review, escalating payment variance trends or issues to NIC management, and generating appeals for denied or underpaid claims.
The Revenue Cycle Clinician for the Appellate Solution is responsible for:
a) Recovering revenue associated with disputed/denied clinical claims or those eligible for clinical review
b) Preparing and documenting appeal based on industry accepted criteria.
Responsible for duties in support of departmental efficiencies which may include: but not limited to performing scheduling, registration, patient pre-admission and admission, reception and discharge functions. Must obtain complete and accurate patient demographic information. Patient Access representatives also must employ proper, compliant patient liability collection techniques before, during & after date of service.
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.