Job Details

Patient Account Senior Representative Remote at Conifer Health Solutions

Job Summary

The Accounts Receivable Senior Representative is responsible for all aspects of follow?up activity, including taking appropriate steps to resolve accounts in a timely manner. This role requires acomprehensive knowledge of the revenue cycle from patient account creation through expected payment, effective follow?up on claim submission and remittance review for insurance collections, and pursuit of disputed balances from both government and non?government entities. Basic knowledge of commercial, managed care, Medicare and Medicaid insurance is preferred. The representative will assist in special projects, support the team, train new staff, and adapt to changing assignments while resolving complex accounts with minimal assistance.

Responsibilities

• Conduct telephone calls with payors and/or patients in a professional demeanor to obtain collection?related information.
• Navigate multiple system applications to determine account actions.
• Access payer websites and discern pertinent data to resolve accounts.
• Utilize all available job aids for follow?up processes.
• Document clear and concise notes in the patient accounting system regarding claim status and actions taken.
• Maintain daily productivity goals while meeting quality standards as determined by leadership.
• Handle complex medical claim issues.
• Identify and communicate any issues, including system access, payor behavior, and workflow inconsistencies.
• Compile data to substantiate and resolve payer, system or escalated account issues.
• Assist new or existing staff with training or techniques to increase production and quality.
• Provide support for team members who are absent or backlogged.

Essential Duties and Responsibilities

• Research each account using company patient accounting applications and internet resources; conduct appropriate account activity on uncollected balances with third?party payors and/or patients via phone, e?mail, or online.
• Problem?solve issues and create resolutions that bring in revenue while eliminating re?work.
• Update plan IDs, adjust patient or payor demographics/insurance information, and notate account details.
• Request additional information from patients, medical records, and other documentation as needed.
• Review contracts to identify billing or coding issues; request re?bills, secondary billing, or corrected bills as necessary.
• Take appropriate action to resolve accounts timely or open dispute records for further research.
• Maintain a current desk inventory and achieve productivity and quality standards.
• Perform special projects, document findings, and communicate results to leaders.
• Escalate payment delays or aged accounts to supervisor promptly.
• Assist with training and quality initiatives as required.
• Participate in meetings, training seminars, and in?services to develop job knowledge.

Knowledge, Skills, and Abilities

• Thorough understanding of the revenue cycle from patient access through Patient Financial Services.
• Good written and verbal communication skills.
• Intermediate technical skills including PC and MS Outlook.
• 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 and federal/state requirements for government payors.
• Advanced knowledge of UB?04 and EOB interpretation.
• Intermediate knowledge of CPT and ICD?9 codes.
• Advanced knowledge of insurance billing, collections and terminology.

Vaccinations and Screenings

Conifer requires candidates to obtain and provide confirmation of all required vaccinations and screenings prior to employment, including COVID?19 and influenza vaccinations.

Education and Experience

• High school diploma or equivalent.
• 2?5 years of experience in medical/hospital insurance?related collections.
• Minimum typing requirement of 45 wpm.

Physical Demands

• Office/Teamwork environment.
• Ability to sit and work at a computer for extended periods of time.

Work Environment

Conifer Health Solutions operates on a remote model. The work environment is fully virtual and requires independent work while maintaining consistent communication with the team.

Compensation and Benefits

• Pay: $17.20 $25.70 per hour (location, qualifications, and experience may affect compensation).
• Possible signing bonus for qualified new hires.
• Conifer observed holidays receive time and a half.
• Medical, dental, vision, disability, and life insurance.
• Paid time off (vacation & sick leave) minimum 12 days per year, accrue at a rate of approximately 1.84 hours per 40 hours worked.
• 401(k) 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, paid leave in accordance with Colorados Healthy Families and Workplaces Act.

Equal Employment Opportunity

Employment practices are not influenced by race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status, or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.

E?Verify

Tenet participates in the E?Verify program. E?Verify.