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 the review of accounts where the patient is covered under an Out of State Medicaid program to ensure all the appropriate enrollment forms are submitted in a timely and efficient manner.
ESSENTIAL DUTIES AND RESPONSIBILITIES Include the following. Others may be assigned.
â�¢ Review and work the MEPRVWOOS delegation control ID, and desks in the following branches 70, 71, 72, ,73 ,74, 75, 77, 78 and 79. â�¢ Thoroughly verify coverage for patients that present Medicaid from states other than the state in which they are receiving care. â�¢ Perform follow-up on submitted enrollment applications within 20-30 days on status. (timelines dependent on state) â�¢ Dispute and or appeal any enrollment applications that have been unjustly denied. â�¢ Maintain a list of OOS application requirements and enrollment activity logs. â�¢ Request updated W9, JACHO, CLIA License, etc from key contacts as needed. â�¢ Completes re-certifications and revalidation to maintain provider credentials active
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.
â�¢ Working familiarity with the rules and regulations pertaining to Federal, State and County programs â�¢ P/C systems literate including Windows, and Micorsoft Outlook, Excel and Word programs â�¢ Ability to work independently â�¢ Excellent oral and written communication skills, as well as the clear understanding of the English language â�¢ Detail oriented, with strengths in dealing with multiple facilites, Supervisors, and Hospital platforms â�¢ Ability to prioritize and manage multiple tasks with efficiency â�¢ Valid Drivers License and auto insurance â�¢ Other duties as assigned
EDUCATION / EXPERIENCE Include minimum education, technical training, and/or experience preferred to perform the job.
â�¢ High School diploma or equivlent â�¢ 2-3 experience in hospital/facility office provider credentialing preferred
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.
â�¢ Must be able to work in sitting position, use computer and answer telephone â�¢ Specific vision abilities required by this job include close vision.
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.
â�¢ Office Work Environment
Job: Conifer Health Solutions
Primary Location: Frisco, Texas
Job Type: PT1
Shift Type: Days
If Other Shift, Specify: Monday, Thursday and Friday from 8:30am to 5:00pm
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: 2105013261
About Conifer Health Solutions
Tenet Healthcare Corporation (NYSE: THC) is a diversified healthcare services company headquartered in Dallas with 112,000 employees. Through an expansive care network that includes United Surgical Partners International, we operate 65 hospitals and approximately 510 other healthcare facilities, including surgical hospitals, ambulatory surgery centers, urgent care and imaging centers and other care sites and clinics. We also operate Conifer Health Solutions, which provides revenue cycle management and value-based care services to hospitals, health systems, physician practices, employers and other clients. Across the Tenet enterprise, we are united by our mission to deliver quality, compassionate care in the communities we serve.