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.

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

• Utilize patient accounting applications, online resources, and payer websites to research accounts.

• Communicate with third-party payers and/or patients via phone, email, or online regarding outstanding balances.

• Update plan IDs along with patient or payer demographic and insurance details.

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

• Identify payer issues and trends, resolve recoup issues, and request additional documentation as needed.

• Review contracts to identify billing or coding issues; request re-bills, secondary billing, or adjustments as necessary.

• Resolve accounts promptly or initiate dispute records for further investigation.

• Maintain desk inventory without backlog while achieving productivity and quality metrics.

• Recognize payment delays and trends in aged accounts; escalate concerns to the Supervisor.

• Provide support to team members who are absent or have a backlog of work.

• Execute special projects and other assigned responsibilities.

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

• Respond promptly to emails and phone 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.

• A minimum typing speed of 45 wpm is necessary.

• Comprehensive understanding of the revenue cycle, from patient access through 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 skills are essential.

• Above-average analytical and critical thinking abilities.

• Capability to make sound decisions.

• Complete 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 terminology and claims 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 follow through on assigned responsibilities.

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

🏝️ Benefits

• Potential eligibility for a signing bonus for qualified new hires, subject to employment status.

• Time and a half pay for observed holidays at Conifer.

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

• Paid time off (vacation & sick leave) – a minimum of 12 days per year.

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

• 10 paid holidays annually.

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

• Employee Assistance program available.

• Employee discount program offered.

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