Physician Services QA Representative (Third Party Follow Up) - Remote

JOB SUMMARY

The primary purpose of this position is to support the Cash Applications and Charge Entry Departments’ quality control program.  It is the intent of Conifer-Physician Services to evaluate all employees on a consistent basis, new hire and tenured, to ensure superior performance for our clients through effective credit balance resolution, payment posting and charge entry. Additionally, the program is designed to identify any potential staff coaching/training opportunities to inspire learning development.

The Quality Assurance Specialist is responsible for evaluating individual employee performance by auditing invoices/accounts worked, using a variety of tools and applications to associate scores and outcomes.  This individual must possess the skills to effectively interact with all staff and leadership with an objective discourse and must be able to handle multiple tasks and priorities with minimal supervision while maintaining confidentiality and meeting compliance guidelines.

ESSENTIAL DUTIES AND RESPONSIBILITIES

Include the following. Others may be assigned.

• Completes audits for representatives through sampling invoices/accounts worked on a consistent basis, per the policies and procedures of the client and/or department
• Documents audit results concisely in an excel spreadsheet, including quality score and any coaching opportunities
• Communicates audit results with leadership in a constructive manner
• Compiles weekly and monthly summary reports and shares trends with leadership
• Provides input surrounding policies/procedures and training documentation, including new policies or modifications to existing policies for the client and/or department
• Participates in staff training when needed
• Participates in calibration sessions as needed
• Facilitates dispute process between employees and leadership
• Other duties as assigned

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.

• Proficient knowledge with Microsoft Office applications (Outlook, Word, Excel)
• Ability to work effectively under tight deadlines, high volumes and multiple interruptions
• Excellent communication and interpersonal skills with ability to influence others from diverse backgrounds and orientations
• Previous experience with practice management systems preferred; Epic, GE Centricity, and NextGen experience a plus
• Strong organization, analytical and problem-solving skills

Conifer requires its candidates, as applicable and as permitted by law, to obtain and provide confirmation of all required vaccinations and screenings prior to the start of employment.  This may include, but is not limited to, the COVID-19 vaccination, influenza vaccination, and/or any future required vaccines and screenings.

EDUCATION / EXPERIENCE

Include minimum education, technical training, and/or experience preferred to perform the job.

• High school diploma or equivalent 
• Minimum of 4 years healthcare experience with good knowledge of revenue cycle

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.           

• Must be able to work in sitting position, use computer and answer telephone

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. 

• Office Work Environment

TRAVEL

• Approximately 0% travel may be required

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!

 

Compensation and Benefit Information

Compensation

• Pay: $17.20-$25.70 per hour. Compensation depends on location, qualifications, and experience. 
• Position may be eligible for a signing bonus for qualified new hires, subject to employment status.
• Conifer observed holidays receive time and a half.

Benefits

Conifer offers the following benefits, subject to employment status:

• 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.

ESSENTIAL DUTIES AND RESPONSIBILITIES

Include the following. Others may be assigned.

 

No. Description % of Time

1.  

Completes audits for representatives through sampling invoices/accounts worked on a consistent basis, per the policies and procedures of the client and/or department 40%

1.  

Documents audit results concisely in an excel spreadsheet, including quality score and any coaching opportunities 10%

1.  

Communicates audit results with leadership in a constructive manner 10%

1.  

Compiles weekly and monthly summary reports and shares trends with leadership 10%

1.  

Provides input surrounding policies/procedures and training documentation, including new policies or modifications to existing policies for the client and/or department 5%

1.  

Participates in staff training when needed 5%

1.  

Participates in calibration sessions as needed 5%

1.  

Facilitates dispute process between employees and leadership 5%

1.  

Other duties as assigned 5% FINANCIAL RESPONSIBILITY (Specify Revenue/Budget/Expense):                                                                                             N/A SUPERVISORY RESPONSIBILITIES 

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. 

 

Direct Reports (titles) N/A Indirect Reports (titles) N/A 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.

• Proficient knowledge with Microsoft Office applications (Outlook, Word, Excel)
• Ability to work effectively under tight deadlines, high volumes and multiple interruptions
• Excellent communication and interpersonal skills with ability to influence others from diverse backgrounds and orientations
• Previous experience with practice management systems preferred; Epic, GE Centricity, and NextGen experience a plus
• Strong organization, analytical and problem-solving skills

 

Conifer requires its candidates, as applicable and as permitted by law, to obtain and provide confirmation of all required vaccinations and screenings prior to the start of employment.  This may include, but is not limited to, the COVID-19 vaccination, influenza vaccination, and/or any future required vaccines and screenings.

EDUCATION / EXPERIENCE

Include minimum education, technical training, and/or experience preferred to perform the job.

 

• High school diploma or equivalent 
• Minimum of 4 years healthcare experience with good knowledge of revenue cycle

REQUIRED CERTIFICATIONS/LICENSURE

Include minimum certification required to perform the job.

• none

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.                           

• Must be able to work in sitting position, use computer and answer telephone

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. 

 

• Office Work Environment

 

TRAVEL

• Approximately 0% travel may be required

OTHER

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