As a part ofthe Tenet and Catholic Health Initiatives family, Conifer Health brings 30years of healthcare industry expertise to clients in more than 135 localregions nationwide. We help our clients strengthen their financial and clinicalperformance, 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 theresources and incentives to redefine healthcare services, with a competitivebenefits package and leadership to take your career to the next step!
Responsible for the reviewof accounts where the patient is covered under an Out of State Medicaid programto ensure all the appropriate enrollment forms are submitted in a timely andefficient manner.
ESSENTIALDUTIES AND RESPONSIBILITIES
Includethe following. Others may be assigned.
Reviewand work the MEPRVWOOS delegation control ID, and desks in the followingbranches 70, 71, 72, 75, 78 and 79.
Thoroughlyverify coverage for patients that present Medicaid from states other than thestate in which they are receiving care.
Performfollow-up on submitted enrollment applications within 30-45 days on status.(timelines dependent on state)
Disputeand or appeal any enrollment applications that have been unjustly denied.
Maintaina list of OOS application requirements.
Requestupdated W9, JACHO, CLIA License, etc from key contacts as needed.
Toperform this job successfully, an individual must be able to perform eachessential duty satisfactorily. The requirements listed below are representativeof the knowledge, skill and/or ability required. Reasonable accommodations maybe made to enable individuals with disabilities to perform the essentialfunctions.
Workingfamiliarity with the rules and regulations pertaining to Federal, State andCounty programs
P/Csystems literate including Windows, and Microsoft Outlook, Excel and Wordprograms
Abilityto work independently
Excellentoral and written communication skills, as well as the clear understanding ofthe English language
Detailoriented, with strengths in dealing with multiple facilities, Supervisors, andHospital platforms
Abilityto prioritize and manage multiple tasks with efficiency
ValidDriverâs License and auto insurance
Otherduties as assigned
Includeminimum education, technical training, and/or experience preferred to performthe job.
HighSchool diploma or equivalent
Minimum2 years work experience with Social Services or Hospital Admitting or relatedarea
Thephysical demands described here are representative of those that must be met byan employee to successfully perform the essential functions of this job.Reasonable accommodations may be made to enable individuals with disabilitiesto perform the essential functions.
Mustbe able to work in sitting position, use computer and answer telephone
Includesability to walk through hospital-based departments across broad campussettings, including Emergency Department environments
Abilityto lift and/or move up to 25 pounds
Specificvision abilities required by this job include close vision.
Mustbe able to drive short distances
Mustbe able to navigate in a hospital environment and visit patients at bedside, ifneeded
Thework environment characteristics described here are representative of those anemployee encounters while performing the essential functions of this job.Reasonable accommodations may be made to enable individuals with disabilitiesto perform the essential functions.
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 applicantâs or employeeâs 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.