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 leading and supervising a team of QA Coordinators performing Quality Inspections and Claim resolution according to Policy and Procedure .The individual collaborates with internal and external business partners to drive accountability, provide recommendation for process improvements and improve overall quality of critical business processes.
ESSENTIAL DUTIES AND RESPONSIBILITIES
Include the following. Others may be assigned.
Monitor QA Coordinators performance in terms of production and Quality Targets.
Reviews audit and Claim resolution workflow to ensure efficiency and Quality of program
Reviews QA statistical data with Patient Access Management, facilities and training on a regular basis to identify problems and trends, and recommended solutions.
Assures resolution of identified billing errors prior to bill drop as required. Tracking and trending outcomes and developing solutions.
Facilitates remote and on-site staff training, development of training guides, reference material and internal documentation.
If direct report positions are listed below, the following responsibilities will be performed 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.
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 verbal and written communication skills
Proficient in the use of MS Office suite. Intermediate-to-Advanced Excel and Word skills required. PowerPoint helpful.
Ability to develop and implement workflow and process plans
Healthcare terminology and reimbursement rules
Insurance Plan payment methodologies and contract terms
Leadership qualities of ownership, personal responsibility and good decision makingolid problem solving capabilities to identify data element and compliance issues, prepare audit reports, and identify trends.
Organizational and prioritization skills sufficient to effectively manage multiple, concurrent initiatives in a deadline-driven environment required.
Self-discipline sufficient to work with minimal supervision required.
Ability to embrace and comply with Conifer Patient Communications policies and Corporate Ethics guidelines required
EDUCATION / EXPERIENCE
Include minimum education, technical training, and/or experience preferred to perform the job.
4 year college degree in Business, Healthcare Management or equivalent Healthcare experience may be substituted for degree
1-2 years experience in Hospital admitting environment or admitting QA
Previous management experience
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.
Must be able to work in sitting position, use computer and answer telephone
Includes ability to walk through hospital-based departments across broad campus settings, including Emergency Department environments
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.
Office Work Environment
Job: Conifer Health Solutions
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: 2005022400
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.