Patient Account Representative (Remote)

Conifer Health brings 30 years of healthcare industry expertise to clients nationwide, helping organizations transition from volume to value-based care, enhance the consumer and patient healthcare experience, and improve quality, cost, and access to healthcare.

About the role

The Patient Account Representative ensures patient accounts are resolved in a timely manner, with a solid understanding of the Revenue Cycle from account creation to payment. This role involves following up on claim submissions, reviewing remittances for insurance collections, and pursuing disputed balances from government and non-government entities. The representative must work independently and collaboratively with management and the team to resolve accounts with minimal assistance.

Responsibilities

• Research accounts using company patient accounting applications and internet resources.
• Conduct appropriate account activity on uncollected balances by contacting third-party payors and/or patients via phone, email, or online.
• Problem-solve issues to create resolutions that bring in revenue and eliminate re-work.
• Update plan IDs, adjust patient or payor demographic/insurance information, notate accounts in detail, identify payor issues and trends, and resolve recoup issues.
• Request additional information from patients, medical records, and other documentation as needed by payors.
• Review contracts to identify billing or coding issues and request re-bills, secondary billing, or corrected bills.
• Take appropriate action to resolve accounts timely or open dispute records for further research.
• Maintain desk inventory to avoid backlog while meeting productivity and quality standards.
• Perform special projects and other duties as assigned, documenting findings and communicating results.
• Recognize potential delays and trends with payors, respond to avoid A/R aging, and escalate payment delays or problem accounts to supervisors.
• Participate in meetings, training seminars, and in-services to develop job knowledge.
• Respond timely to emails and telephone messages.
• Ensure compliance with state and federal laws and regulations for managed care and third-party payors.
• Document clear and concise notes in the patient accounting system regarding claim status and actions taken.
• Maintain department daily productivity goals while meeting quality standards.
• Identify and communicate issues such as system access, payor behavior, workflow inconsistencies, or insurance collection opportunities.
• Provide support for team members who may be absent or backlogged.

Requirements

• High School diploma or equivalent; some college coursework in business administration or accounting preferred.
• 1-4 years of medical claims and/or hospital collections experience.
• Minimum typing requirement of 45 WPM.
• Basic knowledge of Commercial, Managed Care, Medicare, and Medicaid insurance.
• Intermediate skill in Microsoft Office (Word, Excel).
• Ability to learn hospital systems (ACE, VI Web, IMaCS, OnDemand) quickly and fluently.
• Strong interpersonal, oral, and written communication skills.
• Above-average analytical and critical thinking skills.
• Ability to make sound decisions and prioritize duties.
• Intermediate understanding of EOB, hospital billing form requirements (UB04), and familiarity with HCFA 1500 forms.
• Familiarity with terms such as HMO, PPO, IPA, and Capitation, and how these payors process claims.
• Intermediate knowledge of managed care contracts, contract language, and federal/state requirements for government payors.

Skills

• Thorough understanding of the revenue cycle process, from patient access (authorization, admissions) through Patient Financial Services (billing, insurance appeals, collections).
• Ability to work independently and as part of a dynamic team.
• Professional demeanor when interacting with insurance plans, patients, physicians, attorneys, and team members.
• Ability to access payer websites and discern pertinent data to resolve accounts.
• Utilize job aids for appropriateness in Patient Accounting processes.

Physical Demands

• Ability to sit and work at a computer terminal for extended periods.
• Work in a call center environment with multiple workstations in close proximity.

Pay

$15.80 - $23.70 per hour. Compensation depends on location, qualifications, and experience. Position may be eligible for a signing bonus for qualified new hires, subject to employment status.

Benefits

• Medical, dental, vision, disability, and life insurance.
• Paid time off (vacation & sick leave) – minimum of 12 days per year, accrued at approximately 1.84 hours per 40 hours worked.
• 401k with up to 6% employer match.
• 10 paid holidays per year; Conifer-observed holidays receive time and a half.
• Health savings accounts, healthcare & dependent flexible spending accounts.
• Employee Assistance program and Employee discount program.
• Voluntary benefits including 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 Colorado’s Healthy Families and Workplaces Act.