[Remote] Remote- Billing Patient Account Representative

Note: The job is a remote job and is open to candidates in USA. Conifer Health Solutions is a healthcare company that provides financial and clinical performance solutions to clients. They are seeking a Patient Account Representative responsible for resolving patient accounts in a timely manner, following up on claims, and ensuring compliance with regulations.

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 regarding claim status and any actions taken on an account
• 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 familiarity with 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.

Company Overview