Patient Account Representative

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

📋 Description

• Manage patient accounts to ensure prompt resolution.

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

• Create 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 determine necessary account actions.

• Utilize job aids related to Patient Accounting processes.

• Clearly document claim statuses and account actions in the patient accounting system.

• Uphold daily productivity and quality standards.

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

• Provide support to absent or backlogged team members.

• Research accounts using patient accounting applications and online resources.

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

• Update plan IDs and demographic and insurance information for patients and payors.

• Identify payer issues and trends, and resolve recoupment challenges.

• Request necessary information and documentation from patients and medical records.

• Review contracts to identify billing or coding discrepancies and request rebills, secondary billing, or corrected bills.

• Resolve accounts or initiate dispute records for further investigation and ongoing collection efforts.

• Maintain an up-to-date desk inventory without any backlog.

• Undertake special projects and document findings for communication.

• Recognize payer delays and trends, respond to prevent accounts receivable aging, and escalate aged accounts to the Supervisor.

• Attend meetings, training seminars, and in-services as required.

• Promptly respond to emails and telephone messages.

• Ensure adherence to state and federal laws and regulations for Managed Care and other third-party payors.

⛳️ Requirements

• High School diploma or equivalent is required.

• 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 through Patient Financial Services procedures and policies.

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

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

• Clear and professional communication skills are essential.

• Strong oral and written communication abilities.

• Excellent interpersonal skills.

• Above-average analytical and critical thinking capabilities.

• Capability to make informed decisions.

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

• Intermediate knowledge of Managed Care contracts, including contract language and federal and state requirements for government payors.

• Familiarity with HMO, PPO, IPA, and Capitation terms and claims processing.

• Intermediate understanding of Explanation of Benefits (EOB).

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

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

• Ability to obtain and present confirmation of required vaccinations and screenings prior to employment, as applicable and permitted by law.

🏝️ Benefits

• Position may qualify for a signing bonus for eligible new hires, pending employment status.

• Time and a half pay for Conifer observed holidays.

• Comprehensive medical, dental, vision, disability, and life insurance coverage.

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

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

• 10 paid holidays annually.

• Health savings accounts and flexible spending accounts for healthcare and dependents.

• Employee Assistance Program (EAP) available.

• Employee discount program offered.

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

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

• Remote work arrangements may be available.