Tenet Healthcare

Business Development Rep

• Responsible for planning and conducting in-person visits, predominantly focused on key stakeholders across community-based physician groups, post-acute care facilities, and/or non-Tenet acute care facilities throughout the defined market service area, in an effort to increase selection of hospital/market services.
• Evaluate and interpret current physician referral patterns and trends for market facilities’ service lines, ensuring understanding of market dynamics.
• Research portfolio of assigned providers to understand the decision making behind hospital selection. This information should inform provider engagement.
• Conduct face-to-face sales meetings with clients ensuring through understanding of the service line attributes, processes and outcomes to consumers.
• Complete follow-up meetings to ensure internal and external obstacles to growth and retention are identified and minimized.
• Communicate feedback from clients and partner with the appropriate market/hospital resources to resolve issues to better serve our patients and provider partners.
• Prepare and present sales reports, identifying trends, lessons learned, opportunities and areas for improvement to achieve market goals.
• Continuously modify and execute business development tactics to ensure optimal business outcomes, based on feedback from clients and facility leaders.
• Maintain latest knowledge of the health system, hospital and provider landscape, relevant to your specialization, in your defined market service area.
• Document all client engagement in a timely manner on a daily basis in the defined CRM tool, including outcomes and required follow-up.
• Support the implementation of key initiatives that require relevant network development, as directed by the Group Vice President and/or CSO.
• Perform all duties with consistently high ethical standards and strict adherence to company policies and procedures.

Business Development Associate

Medical Billing and Coding

• Assign ICD-10, CPT, HCPCS and modifiers codes from documentation
• Review and appropriately resolve pre-bill edits
• Review and appropriately resolve coding denials
• Meet or exceed productivity standards
• Meet or exceed accuracy rate of 95.5% in monthly internal audits
• Effectively present coding issues to internal team members, internal clients or external clients
• Deliver information in a one-on-one or small group format to peers
• Meet deadlines and complete assignments before monthly closing dates
• Locate and apply CCI, LCD, NCD and other applicable coding rules and client specific guidelines
• Other duties as assigned

Coder III, Surgical

Bilingual

• Responsible for timely scheduling, provide callers with important information related to their appointment
• Verifies patient demographic, insurance information and secures payment of patients financial liability/performing collection efforts
• Collect and verify required patient demographic and financial data elements, including determining a patient’s financial responsibility and securing pre-payment for future services
• Create a complete pre-registration account for an upcoming inpatient/surgical admission
• Completes all pre-certification requirements by obtaining authorization from insurer and/or healthcare facility

Scheduler Representative, Creole Bilingual Required

Collections

• The Patient Account Representative is responsible for working accounts to ensure they are resolved in a timely manner.
• This candidate should have a solid understanding of the Revenue Cycle as it relates to the entire life of a patient account from creation to payment.
• Representative will need to effectively follow-up on claim submission, remittance review for insurance collections, create and pursue disputed balances from both government and non-government entities.
• An effective revenue cycle process is achieved with working as part of a dynamic team and the ability to adapt and grow in an environment where work assignments may change frequently while resolving accounts with minimal assistance.
• Representative must be able to work independently as well as work closely with management and team to take appropriate steps to resolve an account.
• Perform duties as assigned in a professional demeanor, which includes interacting with insurance plans, patients, physicians, attorneys and team members as needed.
• Basic computer skills to navigate through the various system applications provided for additional resources in determining account actions.
• Access payer websites and discern pertinent data to resolve accounts.
• Utilize all available job aids provided for appropriateness in Patient Accounting processes.
• Document clear and concise notes in the patient accounting system regarding claim status and any actions taken on an account.
• Maintain department daily productivity goals in completing a set number of accounts while also meeting quality standards as determined by leadership.
• Identify and communicate any issues including system access, payor behavior, account work-flow inconsistencies or any other insurance collection opportunities.
• Provide support for team members that may be absent or backlogged.
• Researches each account using company patient accounting applications and internet resources that are made available. Conducts appropriate account activity on uncollected account balances with contacting third party payors and/or patients via phone, e-mail, or online.

Business Development Associate

Coder III, Surgical

Scheduler Representative, Creole Bilingual Required

Hospital Collections Representative