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Credit Resolution Analyst - Remote

Company: Conifer Health Solutions
Location: Philadelphia
Posted on: January 16, 2022

Job Description:

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 analyzing, researching and trending toward the resolution and reduction of credit balance refund and adjustment requests within the Regional Business Office Line of Business.

Essential Duties And Responsibilities

include the following. Other duties may be assigned.

  • Research and analyze reports for trending and credit balance reduction initiatives. This includes data for non-Medicare and non-Medicaid accounts, including, but not limited to: Managed Care, Commercial, Self-Pay, and Unapplied accounts with focus on reduction of new inflow of credits.
  • Monitors and provides feedback on third party vendor on volumes, productions and quality. Create and maintain censor or staff work instructions based upon trending analysis or management request.
  • Preparation of monthly summary reports to be submitted to Site Directors and Reimbursement Managers. These reports include but are not limited to compliance related reports to high dollar credit balances, auto approved refunds/adjustment, month end finance reporting and other variance reporting.
  • Other duties as assigned by management.

    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.

    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.
    • Advanced analytical skills
    • Advanced knowledge of: Excel, ACE, and MediFinance
    • Experience in the analysis of payer trends regarding credits, adjustments and refunds
    • Strong attention to detail
    • Demonstrated ability to detect patterns in large volumes of data
    • Advanced knowledge of Managed Care and other healthcare contract language
    • Independent, proactive thinker
    • Other duties as assigned by management
      Education / Experience

      Include minimum education, technical training, and/or experience preferred to perform the job.
      • 4 year college degree in Healthcare Management, Finance or related area preferred, or, equivalent job experience
      • 3 - 5 years experience working with insurance payers in a medical/healthcare environment
      • 2 - 3 years experience in analysis of payer trends, credits, adjustments and refunds

        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 sit at a computer for extended periods of time

          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.
          • General office environment
            • May require travel - approximately 40%
              Job: Conifer Health Solutions

              Primary Location: Frisco, Texas

              Job Type: Full-time

              Shift Type: Days

Keywords: Conifer Health Solutions, Philadelphia , Credit Resolution Analyst - Remote, Professions , Philadelphia, Pennsylvania

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