Job Summary
The SPEC, PHYS SVC EDIT is responsible for the processing and monitoring of claim edits.
The SPEC, PHYS SVC EDIT ensures claims are correct by analyzing TES edits, claim form requirements and rejections.
Essential Duties And Responsibilities
Include the following. Others may be assigned.
Resolve daily clearinghouse edits
Resolve daily host system claim form edits
Resolve edits within EPIC Edit WQ’s, Retro, etc
Resolve Statement/Return Mail address edits
Print Medical Records/Documentation
Contact various insurance carriers to resolve edits
Responsible for reviewing accounts, verifying eligibility, updating registration, rebill activities and leaving detailed account notes
Meets or Exceeds department Productivity standard 20 invoices/hour depending on client worked
Meets or Exceeds Quality Assurance standard of 95% or higher
Communicate with clients via email
Train new hires
Other duties may be assigned
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.
Good problem solving and analytical skills
Good communication skills
Good organizational skills and priority planning
Ability to perform essential job functions with moderate degree of independence, flexibility, and creative problem-solving techniques
Attentive listening skills
Good attention to detail
Ability to Multi-task
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.
Education / Experience
Include minimum education, technical training, and/or experience preferred to perform the job.
High School diploma or equivalency required
1-4yrs IDX/EPIC/Next Gen experience
1-4yrs Collection or Medical insurance billing experience
Moderate Excel knowledge
Ability to work independently and multi-task various assignments
Good written and oral communication skills
Good problems solving and analytical skills
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 work additional hours as needed
Ability to work in a fast-paced environment
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.
Business office environment
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!
Compensation
Compensation and Benefit Information
Pay: $13.40 - $20.00 per hour. Compensation depends on location, qualifications, and experience.
Position may be eligible for a signing bonus for qualified new hires, subject to employment status.
Conifer observed holidays receive time and a half.
Benefits
Conifer offers the following benefits, subject to employment status:
Medical, dental, vision, disability, and life insurance
Paid time off (vacation & sick leave) – min of 12 days per year, accrue at a rate of approximately 1.84 hours per 40 hours worked.
401k with up to 6% employer match
10 paid holidays per year
Health savings accounts, healthcare & dependent flexible spending accounts
Employee Assistance program, Employee discount program
Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, AD&D, auto & home insurance.
For Colorado employees, Conifer offers paid leave in accordance with Colorado’s Healthy Families and Workplaces Act.
2503009750
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.
, $13.40 - $20.00 hourly **Individual wages are determined based upon a number of factors including, but not limited to, an individual’s qualifications and experience