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 review remittances for insurance collection

• Generate and pursue disputed balances from both governmental and non-governmental entities

• Engage with insurance providers, patients, healthcare professionals, attorneys, and team members

• Utilize computer systems and payer websites to determine necessary account actions

• Document clear and concise notes regarding claim statuses and account activities

• Maintain daily productivity and quality standards while completing account inventories

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

• Provide assistance for absent or overburdened team members

• Research accounts utilizing patient accounting applications and online resources

• Communicate with third-party payors and patients via phone, email, or online

• Update plan IDs and demographic information for patients or payors, along with their insurance details

• Identify payer issues and trends, addressing recoupment problems

• Request necessary patient and medical records or documentation from payors

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

• Resolve accounts in a timely manner or initiate dispute records for further investigation

• Undertake special projects and other assigned responsibilities

• Recognize payer delays and trends, implement corrective actions, and escalate aged accounts to the Supervisor

• Participate in meetings, training seminars, and in-services

• 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

• 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 to Patient Financial Services 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

• Clear and professional communication skills, both oral and written

• Strong interpersonal abilities

• Above-average analytical and critical thinking capabilities

• Capacity to make informed decisions

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

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

• Familiarity with HMO, PPO, IPA, and Capitation terms as well as claim processing

• 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 complete assigned responsibilities

• Capability to sit and work at a computer terminal for extended periods

• Conifer requires candidates, where applicable and permitted by law, to obtain and provide proof of required vaccinations and screenings before employment

🏝️ Benefits

• Position may qualify for a signing bonus for eligible new hires, subject to employment status

• Conifer observed holidays are compensated at time and a half

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

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

• 401k plan with an employer match of up to 6%

• 10 paid holidays annually

• Health savings accounts, along with healthcare and dependent flexible spending accounts

• Employee Assistance Program available

• Employee discount program offered

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

• For employees in Colorado, compensated leave in accordance with Colorado’s Healthy Families and Workplaces Act