Patient Account Representative

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

📋 Description

• Manage accounts to ensure timely resolution.

• Follow up on claim submissions and examine remittances for insurance collections.

• Generate and pursue disputed balances from both government and non-government entities.

• Collaborate with insurance plans, patients, physicians, attorneys, and team members.

• Navigate system applications and payer websites to assess account actions.

• Document clear and concise notes regarding the status of claims and actions taken.

• Maintain daily productivity targets while adhering to quality standards.

• Identify and communicate issues related to system access, payer behavior, workflows, and insurance collections.

• Provide assistance for team members who are absent or experiencing backlogs.

• Research accounts utilizing patient accounting applications and online resources.

• Contact third-party payors and patients via phone, email, or online regarding outstanding balances.

• Resolve issues, update plan IDs, adjust patient or payor demographic and insurance information, and identify payer trends.

• Request information and documentation from patients, medical records, and other sources.

• Review contracts and pinpoint billing or coding discrepancies; request rebills, secondary billing, or corrected bills.

• Take prompt action to resolve accounts or initiate dispute records for further investigation.

• Maintain desk inventory without backlog while meeting productivity and quality standards.

• Execute special projects and other assigned responsibilities.

• Identify payer delays and trends, take corrective measures, and escalate aged accounts to the Supervisor.

• Attend meetings, training seminars, and in-service sessions.

• Respond promptly to emails and phone messages.

• Ensure compliance with state and federal laws and regulations regarding Managed Care and other third-party payors.

⛳️ Requirements

• High School diploma or equivalent required.

• 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 through Patient Financial Services procedures and policies.

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

• Ability to quickly and proficiently learn hospital systems – ACE, VI Web, IMaCS, OnDemand.

• Full understanding of Commercial, Managed Care, Medicare, and Medicaid collections.

• Intermediate knowledge of Managed Care contracts, contract language, and Federal and State regulations for government payors.

• Familiarity with HMO, PPO, IPA, and Capitation, and 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.

• Ability to problem-solve, prioritize responsibilities, and complete assigned tasks thoroughly.

• Excellent communication skills in both verbal and written forms.

• Strong interpersonal abilities.

• Above-average analytical and critical thinking capabilities.

• Ability to make informed decisions.

• Additional college coursework in business administration or accounting is preferred.

• Required vaccinations and screenings, as applicable and permitted by law, prior to the start of employment.

🏝️ Benefits

• Position may be eligible for a signing bonus for qualified new hires, contingent upon employment status.

• Conifer observed holidays provide time and a half pay.

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

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

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

• 10 paid holidays per year.

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

• Employee Assistance program.

• 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 provides paid leave in accordance with Colorado’s Healthy Families and Workplaces Act.

• Competitive benefits package.

• Leadership support to advance your career.