Patient Account Representative – Contract

📋 Description

• The Patient Account Representative plays a crucial role in managing accounts to ensure timely resolutions.

• Efficiently follow up on claim submissions, review remittances for insurance collections, and create as well as pursue disputed balances from both government and non-government sources.

• Investigate each account utilizing company patient accounting applications and online resources. Perform necessary actions on uncollected account balances by contacting third-party payors and/or patients via phone, email, or online.

• Address problems and devise solutions that will generate revenue while minimizing re-work.

• Update plan IDs, modify patient or payor demographic/insurance details, document accounts thoroughly, identify payor issues and trends, and resolve recoupment challenges.

• Request additional details from patients, medical records, and other necessary documentation as needed by payors.

• Maintain desk inventory to stay current without backlog, while meeting productivity and quality benchmarks.

• Carry out special projects and other assigned duties. Document findings and communicate results for special projects as required.

• Respond promptly to emails and phone messages as necessary.

⛳️ 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) through Patient Financial Services (billing, insurance appeals, collections) 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.

• Strong ability to communicate clearly and professionally.

• Excellent oral and written communication skills.

• Strong interpersonal abilities.

• Above-average analytical and critical thinking capabilities.

• Ability to make informed decisions.

• Comprehensive 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 payors.

• Familiarity with terms like HMO, PPO, IPA, and Capitation, and how these payors process claims.

• Intermediate knowledge of Explanation of Benefits (EOB).

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

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

🏝️ Benefits

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

• 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 each year.

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

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