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 conducting quality audits on patient services and bills within 48 hours of discharge, correcting errors, and noting trends. Also, QA is responsible for providing web-based training from remote location.
ESSENTIAL DUTIES AND RESPONSIBILITIES
Include the following. Others may be assigned.
Completes quality assurance (QA) audits of specified number of patient accounts within XX hours of registration and prior to bill drop responsible for conducting quality audits on patient services and bills within 48 hours of discharge, correcting errors, and
Resolves identified billing errors prior to bill drop as required.
Audits accounts to ensure:
all demographic, insurance payer information, and signatures are required and documented correctly;
compliance standards in accordance to federal and agency regulations;
all benefits and authorizations are obtained and documented;
quality assurance standards are met.
Reviews QA statistical data with Patient Access management & department heads, facilities and training on a regular basis to identify problems and trends, and recommend solutions.
Facilitates remote and on-site training based on QA trends to increase proficiency with departmental standards and to improve billing integrity.
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 verbal and written communication skills
Solid problem-solving capabilities to identify data element and compliance issues, prepare audit reports, and identify trends
Demonstrate proficiency of Microsoft software products and personal computer. QA software experience is preferred.
Ability to pay attention to details.
EDUCATION / EXPERIENCE
Include minimum education, technical training, and/or experience preferred to perform the job.
High school diploma or equivalent
Some college, 4 year college degree in Healthcare Administration, Business or related field preferred
Minimum of 2 years of experience in Patient Access
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
Ability to travel
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
Hospital Work Environment
Travel required, as needed
Job: Patient Access
Primary Location: Worcester, Massachusetts
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: 1905047520
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.