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Conifer Health Solutions · 18 hours ago

Remote- Billing Patient Account Representative

United States

Full-time

Remote

Entry, Mid Level

$15.80/hr - $23.70/hr

1+ years exp

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.

Health Care

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

Qualification

Revenue Cycle KnowledgeMedical Claims ExperienceInsurance Collections KnowledgeMicrosoft OfficeHospital Billing KnowledgeAnalytical SkillsInterpersonal SkillsProblem SolvingCommunication Skills

Required

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

Preferred

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.