Patient Account Representative
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Job Description
Patient Account Representative resolving medical claims, billing, and collections accounts for Conifer Health. Supporting healthcare clients’ financial performance through accurate account research and payer follow-up.
Responsibilities:
- Work patient accounts to ensure timely resolution
- Follow up on claim submissions and review remittances for insurance collections
- Create and pursue disputed balances from government and non-government entities
- Interact with insurance plans, patients, physicians, attorneys, and team members
- Navigate system applications and payer websites to determine account actions
- Use job aids for Patient Accounting processes
- Document claim status and account actions clearly in the patient accounting system
- Maintain daily productivity and quality standards
- Identify and communicate system access, payer behavior, workflow, and insurance collection issues
- Support absent or backlogged team members
- Research accounts using patient accounting applications and internet resources
- Contact third-party payors and patients by phone, email, or online regarding uncollected balances
- Update plan IDs and patient or payor demographic and insurance information
- Identify payor issues and trends and resolve recoupment issues
- Request information and documentation from patients and medical records
- Review contracts, identify billing or coding issues, and request rebills, secondary billing, or corrected bills
- Resolve accounts or open dispute records for further research and continued collection
- Maintain current desk inventory without backlog
- Perform special projects and document and communicate findings
- Recognize payor delays and trends, respond to avoid accounts receivable aging, and escalate delayed or aged accounts to the Supervisor
- Attend meetings, training seminars, and in-services
- Respond timely to emails and telephone messages
- Ensure compliance with state and federal laws and regulations for Managed Care and other third-party payors
Requirements:
- High School diploma or equivalent
- 1-4 years medical claims and/or hospital collections experience
- Minimum typing requirement of 45 wpm
- Thorough understanding of the revenue cycle process, from patient access through Patient Financial Services procedures and policies
- Intermediate skill in Microsoft Office (Word, Excel)
- Ability to learn hospital systems – ACE, VI Web, IMaCS, OnDemand quickly and fluently
- Clear and professional communication skills
- Good oral and written skills
- Strong interpersonal skills
- Above average analytical and critical thinking skills
- Ability to make sound 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 and claims processing
- Intermediate understanding of EOB
- Intermediate understanding of hospital billing form requirements (UB04) and familiarity with HCFA 1500 forms
- Ability to problem solve, prioritize duties, and follow through completely with assigned tasks
- Ability to obtain and provide confirmation of required vaccinations and screenings prior to employment, as applicable and permitted by law
Benefits:
- Position may be eligible for a signing bonus for qualified new hires, subject to employment status
- Conifer observed holidays receive time and a half
- Medical, dental, vision, disability, and life insurance
- Paid time off (vacation & sick leave) – min of 12 days per year, accrue at a rate of approximately 1.84 hours per 40 hours worked
- 401k with up to 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 offers paid leave in accordance with Colorado’s Healthy Families and Workplaces Act
- Remote work arrangement
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