Revenue Recovery Coordinator

Tenet Healthcare; Honolulu (HI); On-site; USD 30,858 - 46,438; Full time

Benefits offered by this job

Medical, dental, vision, disability, &

Life insurance

Paid time off

401(k) with employer match

Paid holidays

Health savings accounts

Employee assistance program

Voluntary benefits

Job summary

Tenet Healthcare's Conifer Health division seeks a detail‑oriented refunds outreach specialist to manage outstanding refunds for managed groups, engaging with providers and payers on overpaid claims and reimbursement issues.

You will review dashboards, coordinate discrepancies, post refunds in EZ Cap, assist with document management, and support capitation audit processes. A high school diploma is required; a bachelor's degree is preferred, and experience with EZ Cap 6x is a plus.

Qualifications

• High School Diploma or GED required.
• Bachelor’s Degree preferred.
• IPA/Hospital collection experience preferred.
• Experience working with providers and health plans preferred.
• Experience with EZ Cap 6x preferred.

Responsibilities

• Provider outreach for outstanding refunds for all managed groups.
• Engages with providers and payers on issues pertaining to overpaid claims and reimbursement.
• Creates incidents to update issues found regarding contracts, eligibility claims processing.
• Review dashboard to address past-due refund requests and overpaid claims due to system or processing errors.
• Coordinate discrepancies with supervisor.
• Assist with posting refund checks by coding refunds received and entering the amount in EZ Cap for monthly reconciliation.
• Assist with maintenance of the Macess Document Management system.
• Assist with overpayments identified through capitation deduction audits.
• Perform all other job-related duties and special projects as delegated by management.

Skills

Effective writing

Communication skills

Analytical thinking

Matrixed teamwork

MS Office (Word and Excel)

Education

High School Diploma or GED

Bachelor’s Degree preferred

Tools

EZ Cap 6x

Job description

Company Overview

Conifer Health is part of the Tenet and Catholic Health Initiatives family, bringing 30 years of healthcare industry expertise to clients in more than 135 regions nationwide. We help strengthen financial and clinical performance, serve communities, and succeed in the business of healthcare by transitioning from volume‑to‑value based care and enhancing patient experience.

Job Summary

Performs provider outreach for all outstanding refunds for all managed groups. Engages with providers and payers on issues pertaining to overpaid claims and reimbursement. Creates incidents to update issues found regarding contracts, eligibility claims processing.

Essential Duties and Responsibilities

• Provider outreach for outstanding and provider‑initiated refund requests via phone, fax, and email.
• Review dashboard to address past‑due refund requests and overpaid claims due to system or processing errors.
• Coordinate discrepancies with supervisor.
• Assist with posting refund checks by coding refunds received and entering the amount in EZ Cap for monthly reconciliation.
• Assist with maintenance of the Macess Document Management system.
• Assist with overpayments identified through capitation deduction audits.
• Perform all other job‑related duties and special projects as delegated by management.

Knowledge, Skills, and Abilities

• Effective writing and communication skills.
• Demonstrated analytical and problem‑solving skills.
• Partner effectively within a matrixed organization.
• Proficient with Microsoft Office Software (Word and Excel).

Vaccination Requirement

Conifer requires candidates, as permitted by law, to obtain and provide confirmation of all required vaccinations and screenings before employment. This may include, but is not limited to, COVID‑19 vaccination, influenza vaccination, and any future required vaccines and screenings.

Education and Experience

• High School Diploma or GED required.
• Bachelor’s Degree preferred.
• IPA/Hospital collection experience preferred.
• Experience working with providers and health plans preferred.
• Experience with EZ Cap 6x preferred.

Certifications and Licensure

No certifications or licensure required.

Physical Demands

Must be able to work in a seated position, use a computer, and answer the telephone; light physical effort (lifting up to 10 lbs).

Work Environment

Office work environment.

Travel

None.

Compensation

Pay: $22.40–$33.71 per hour. Shift differentials of $1.00–$2.50 per hour may be available depending on the shift worked. Conifer observes holidays and pays time and a half.

Benefits

• Medical, dental, vision, disability, and life insurance.
• Paid time off (vacation & sick leave) – minimum 12 days per year, accruing at ~1.84 hours per 40 hours worked.
• 401(k) with up to 6% employer match.
• 10 paid holidays per year.
• Health savings accounts and dependent flexible spending accounts.
• Employee assistance program and employee discount program.
• Voluntary benefits (pet, legal, accident & critical illness, long‑term care, elder & childcare, AD&D, auto, and home insurance).

Equal Opportunity and Accommodation Policy

Employment practices will not be influenced or affected by an applicant’s or employee’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.