Patient Account 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.

• The representative will effectively follow up on claim submissions, review remittances for insurance collections, and create and pursue disputed balances from both government and non-government entities.

• Duties must be performed in a professional manner, which includes engaging with insurance plans, patients, physicians, attorneys, and team members as necessary.

• Basic computer skills are required to navigate various system applications that provide additional resources for determining account actions.

• Access payer websites and analyze relevant data to resolve accounts.

• Utilize all available job aids to ensure appropriateness in Patient Accounting processes.

• Maintain clear and concise documentation in the patient accounting system regarding claim status and actions taken on each account.

• Meet departmental daily productivity goals by completing a designated number of accounts while adhering to quality standards set by leadership.

• Identify and report any issues related to system access, payer behavior, workflow inconsistencies, or other opportunities for insurance collections.

• Provide assistance to team members who may be absent or experiencing backlogs.

⛳️ 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 words per minute.

• 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).

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

• Ability to communicate clearly and professionally.

• Strong oral and written communication skills.

• Excellent interpersonal skills.

• Above-average analytical and critical thinking abilities.

• Capability to make sound decisions.

• Thorough 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 payers.

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

• Intermediate understanding of Explanation of Benefits (EOB).

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

• Strong problem-solving skills, ability to prioritize tasks, and follow 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 6% employer match.

• 10 paid holidays each year.

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

• Employee Assistance program and Employee discount program.

• Voluntary benefits including pet insurance, legal insurance, accident and critical illness insurance, long-term care, elder & childcare, AD&D, auto & home insurance.

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