Note: The job is a remote job and is open to candidates in USA. Conifer Health Solutions is a company with over 30 years of expertise in the healthcare industry, serving clients across more than 135 regions nationwide. They are seeking a Credit Resolution Representative responsible for performing refunds and credit analyses functions within the Hospital Revenue Cycle Management team, ensuring appropriate actions are taken to resolve credit balances for patient accounts.
Responsibilities
- Performs refund and credit analyses, audit and reimbursement functions for all Managed Care, Commercial, Medicare, Medicaid, Self-pay and third party payors for all patient accounts
- Determines if credit balance is an over contractual, late charges applied, overpayment etc. to ensure appropriate actions are taken to resolve
- Performs Quarterly reviews for Medicare and Medicaid (based on state guidelines) and submits to client for approval, signature and submission
- Manage and maintain desk inventory, complete reports, and resolve high priority and aged inventory Accurately and thoroughly documents the pertinent credit balance review activity performed
- Communicate issues to management, including payer, system or escalated account issues
- Handle correspondence received from payers and patients requesting refunds
- Respond timely to emails and telephone messages as appropriate
- Participate and attend meetings, training seminars and in-services to develop job knowledge
- Other duties as assigned by Management
Skills
- Entry level understanding of hospital billing form requirements (UB04 and HCFA 1500)
- Entry level knowledge of ICD-10, HCPCS/CPT coding and medical terminology
- Entry level writing skills
- Understanding and interpretation of Managed Care contracts
- Understanding of Gov't Medicare and multiple state Medicaid programs payor regulations (if Gov't team)
- High School Diploma or equivalent experience
- 1 – 3 years' experience in a hospital business environment performing billing and/or follow-up functions
- Ability to sit and work at a computer terminal for extended periods of time
- Entry level knowledge of ACE/PBAR/STAR/Meditech or EPIC
- Contract Interpretation skills greatly preferred
Benefits
- Medical, dental, vision, disability, and life insurance
- Paid time off (vacation & sick leave) – min of 12 days per year, accrue at a rate of approximately 1.84 hours per 40 hours worked.
- 401k with up to 6% employer match
- 10 paid holidays per year
- Health savings accounts, healthcare & dependent flexible spending accounts
- Employee Assistance program, Employee discount program
- Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, AD&D, auto & home insurance.
- For Colorado employees, Conifer offers paid leave in accordance with Colorado’s Healthy Families and Workplaces Act.
Company Overview
Conifer Health Solutions is a healthcare services company helping organizations strengthen their financial performance It was founded in 2008, and is headquartered in Frisco, Texas, USA, with a workforce of 10001+ employees. Its website is http://coniferhealth.com/.Company H1B Sponsorship
Conifer Health Solutions has a track record of offering H1B sponsorships, with 5 in 2025, 3 in 2024. Please note that this does not guarantee sponsorship for this specific role.
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