Note: The job is a remote job and is open to candidates in USA. Conifer Health Solutions is a company that specializes in healthcare services, focusing on enhancing financial and clinical performance. They are seeking a Patient Account Representative responsible for managing patient accounts through the revenue cycle, ensuring timely resolution of claims, and collaborating with various stakeholders to improve collections and account management.
Responsibilities
- Researches each account using company patient accounting applications and internet resources that are made available. Conducts appropriate account activity on uncollected account balances with contacting third party payors and/or patients via phone, e-mail, or online. Problem solves issues and creates resolution that will bring in revenue eliminating re-work. Updates plan IDs, adjusts patient or payor demographic/insurance information, notates account in detail, identifies payor issues and trends and solves re-coup issues. Requests additional information from patients, medical records, and other needed documentation upon request from payors. Reviews contracts and identify billing or coding issues and request re-bills, secondary billing, or corrected bills as needed. Takes appropriate action to bring about account resolution timely or opens a dispute record to have the account further researched and substantiated for continued collection. Maintains desk inventory to remain current without backlog while achieving productivity and quality standards
- Perform special projects and other duties as needed. Assists with special projects as assigned, documents, findings, and communicates results
- Recognizes potential delays and trends with payors such as corrective actions and responds to avoid A/R aging. Escalates payment delays/ problem aged account timely to Supervisor
- Participate and attend meetings, training seminars and in-services to develop job knowledge
- Respond timely to emails and telephone messages as appropriate
- Ensures compliance with State and Federal Laws Regulations for Managed Care and other Third Party Payors
Skills
- Solid understanding of the Revenue Cycle as it relates to the entire life of a patient account from creation to payment
- Ability to effectively follow-up on claim submission, remittance review for insurance collections
- Ability to create and pursue disputed balances from both government and non-government entities
- Basic knowledge of Commercial, Managed Care, Medicare and Medicaid insurance
- Ability to work independently as well as closely with management and team
- Professional demeanor when interacting with insurance plans, patients, physicians, attorneys and team members
- Basic computer skills to navigate through various system applications
- Ability to access payer websites and discern pertinent data to resolve accounts
- Ability to document clear and concise notes in the patient accounting system
- Ability to maintain department daily productivity goals while meeting quality standards
- Ability to identify and communicate any issues including system access, payor behavior, account work-flow inconsistencies
- Ability to provide support for team members that may be absent or backlogged
- 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 quickly and fluently
- Ability to communicate in a clear and professional manner
- Good oral and written skills
- Strong interpersonal skills
- Above average analytical and critical thinking skills
- Ability to make sound decisions
- Full understanding of the 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 terms such as HMO, PPO, IPA and Capitation
- Intermediate understanding of EOB
- Intermediate understanding of Hospital billing form requirements (UB04) and familiar with the HCFA 1500 forms
- Ability to problem solve, prioritize duties and follow-through completely with assigned tasks
- High School diploma or equivalent
- 1-4 years medical claims and/or hospital collections experience
- Minimum typing requirement of 45 wpm
- Some college coursework in business administration or accounting
Benefits
- 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.
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