Patient Account Representative

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

📋 Description

• The Patient Account Representative is tasked with managing accounts to ensure they are resolved promptly.

• This individual should possess a comprehensive understanding of the Revenue Cycle as it pertains to the entire lifespan of a patient account from inception to payment.

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

• Execute assigned duties in a professional manner, including interactions with insurance plans, patients, physicians, attorneys, and team members as required.

• Basic computer proficiency to navigate various system applications provided for additional resources in determining account actions.

• Access payer websites and extract pertinent information to resolve accounts.

• Document clear and concise notes in the patient accounting system regarding claim status and any actions taken on an account.

• Maintain daily productivity targets within the department by completing a set number of accounts while also adhering to quality standards established by leadership.

• Identify and report any issues, including system access problems, payer behavior inconsistencies, account workflow discrepancies, or any other insurance collection opportunities.

• Provide support to team members who may be absent or facing a backlog.

⛳️ 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) through Patient Financial Services (billing, insurance appeals, collections) procedures and policies.

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

• Ability to quickly and fluently learn hospital systems such as ACE, VI Web, IMaCS, and OnDemand.

• Capable of communicating in a clear and professional manner.

• Must have strong oral and written communication skills.

• Excellent interpersonal skills.

• Above-average analytical and critical thinking abilities.

• Ability to make informed decisions.

• Full 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 and their claims processing methods.

• Intermediate understanding of Explanation of Benefits (EOB).

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

• Ability to problem-solve, prioritize tasks, and follow through on assigned duties completely.

🏝️ 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, healthcare & 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, AD&D, auto & home insurance.

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