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!
Responsible for researching, identifying and implementing regulatory changes to billing systems and edit systems. Responsible for tracking and communication of system changes, impact to billing requirements and policy changes to management.
ESSENTIAL DUTIES AND RESPONSIBILITIES
Include the following. Other duties may be assigned.
Research, identify and notify key stake holders of regulatory changes
Assists business stakeholder with understanding information and supports business stakeholder in defining reporting and system enhancement needs
Review and provide feedback to managed care contracts
Review, approve as appropriate and monitor all third party edits
Assist with compliance and CIA related matters
Develop and maintain working relationship with HCOs and RCOs ensuring billing compliance and claim integrity
Assist with the development and implementation of new billing policy ensuring the integrity of claims
Develop communications and agendas for billing manager meetings, advisory and user groups
Lead special projects as assigned by Director
This position carries out supervisory responsibilities in accordance with guidelines, policies and procedures and applicable laws. Supervisory responsibilities include interviewing, hiring, and training employees; planning, assigning and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.
Direct Reports (incl. titles): N/A
No. Indirect Reports (incl. titles): 1 Analyst
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.
Excellent communication, customer service and time-management skills
Good interpersonal skills and ability to work well with other team members and customer/business stakeholders
Ability to define and document requirements for system enhancements based on business stakeholder requests
Analytical ability to create/run system queries (ACE, PBAR), as required
Extensive problem-solving and organizational skills
High level business skills and understanding of general financial operations and major A/R goals in the healthcare environment
Strives for continuous improvement through training and other learning opportunities
Detail-oriented, meticulous, and accurate in completing tasks timely
Ability to design and implement reporting from the systems necessary to collect, maintain, and analyze information
Proficient (medium to high skill level) with various desktop applications, such as Microsoft Excel, Word and/or Access
EDUCATION / EXPERIENCE
Include minimum education, technical training, and/or experience required to perform the job.
B.S. degree in Business or Healthcare related field (preferred)
7-10 yearsï¿½ business or healthcare business office experience and management experience
1-2 yearsï¿½ experience in delivering services to internal/external clients
Project management/facilitation training experience (preferred)
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.
While performing the duties of this job, the employee is regularly required to sit for long periods of time; use of hands and fingers; reaching with hands and arms; talk and hear. Specific vision abilities required by this job include close vision.
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.
Normal corporate office environment
Job: Managers and Directors
Primary Location: Frisco, Texas
Job Type: Full-time
Shift Type: Days
Employment practices will not be influenced or affected by an applicantâ��s or employeeâ��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.
Internal Number: 1905026908
About Conifer Health Solutions
“Tenet Healthcare Corporation is a diversified healthcare services company with 115,000 employees united around a common mission: to help people live happier, healthier lives. Through its subsidiaries, partnerships and joint ventures, including United Surgical Partners International, the Company operates general acute care and specialty hospitals, ambulatory surgery centers, urgent care centers and other outpatient facilities. Tenet's Conifer Health Solutions subsidiary provides technology-enabled performance improvement and health management solutions to hospitals, health systems, integrated delivery networks, physician groups, self-insured organizations and health plans.