Hospital Account Collections Representative

This is a fully remote position, open to applicants in United States.

📋 Description

• The Patient Account Representative is tasked with managing accounts to ensure timely resolution.

• Responsible for following up on claim submissions, reviewing remittances for insurance collections, and creating and pursuing disputed balances from both governmental and non-governmental entities.

• Conducts thorough research on each account utilizing company patient accounting applications and available internet resources.

• Engages in appropriate account activities regarding uncollected balances by contacting third-party payors and/or patients via phone, email, or online platforms.

• Identifies and resolves issues effectively to generate revenue and minimize rework.

• Updates plan IDs, modifies patient or payor demographic/insurance information, provides detailed account notes, identifies payor issues and trends, and addresses recoupment issues.

• Solicits additional information from patients, medical records, and other necessary documentation as requested by payors.

• Reviews contracts to identify any billing or coding discrepancies and requests re-bills, secondary billing, or corrected bills as required.

• Takes necessary actions to achieve timely account resolution or initiates a dispute record for further research and substantiation for ongoing collections.

• Manages desk inventory to maintain current status without backlog while meeting productivity and quality standards.

⛳️ Requirements

• High School diploma or equivalent; some college coursework in business administration or accounting is preferred.

• 1-4 years of experience in medical claims and/or hospital collections.

• Minimum typing speed of 45 wpm.

• Comprehensive understanding of the revenue cycle process, from patient access (authorization, admissions) to Patient Financial Services (billing, insurance appeals, collections) procedures and policies.

• Intermediate proficiency in Microsoft Office (Word, Excel).

• Capacity to quickly and fluently learn hospital systems – ACE, VI Web, IMaCS, OnDemand.

• Ability to communicate clearly and professionally.

• Strong oral and written communication skills.

• Excellent interpersonal abilities.

• Above-average analytical and critical thinking skills.

• Ability to make informed decisions.

• In-depth understanding of Commercial, Managed Care, Medicare, and Medicaid collections, along with intermediate knowledge of Managed Care contracts, contract language, and federal and state requirements for government payors.

• Familiarity with terms such as HMO, PPO, IPA, and Capitation, as well as how these payors process claims.

• Intermediate understanding of Explanation of Benefits (EOB).

• Intermediate knowledge of hospital billing form requirements (UB04) and familiarity with HCFA 1500 forms.

• Proficient in problem-solving, prioritizing tasks, and following through on assigned responsibilities.

🏝️ Benefits

• Medical, dental, vision, disability, and life insurance.

• Paid time off (vacation & sick leave) – a minimum of 12 days per year, accruing at a rate of approximately 1.84 hours per 40 hours worked.

• 401k plan with up to a 6% employer match.

• 10 paid holidays each year.

• Health savings accounts, as well as healthcare and dependent flexible spending accounts.

• Employee Assistance program and Employee discount program.

• Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long-term care, elder & childcare, accidental death & dismemberment, and auto & home insurance.

• For employees in Colorado, Conifer provides paid leave in compliance with Colorado’s Healthy Families and Workplaces Act.