Patient Account Representative – Contract

Job Description: The Patient Account Representative is responsible for working accounts to ensure they are resolved in a timely manner.Follow-up on claim submission, remittance review for insurance collections, create and pursue disputed balances from both government and non-government entities.Perform duties as assigned in a professional demeanor, interacting with insurance plans, patients, physicians, attorneys and team members as needed.Research each account using company patient accounting applications and internet resources available. Conduct appropriate account activity on uncollected account balances contacting third party payors and/or patients via phone, e-mail, or online.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.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 and escalates payment delays/problem aged accounts timely to Supervisor.Participate and attend meetings, training seminars and in-services to develop job knowledge.Ensures compliance with State and Federal Laws Regulations for Managed Care and other Third Party Payors.Requirements: High School diploma or equivalent. Some college coursework in business administration or accounting preferred1-4 years medical claims and/or hospital collections experienceMinimum typing requirement of 45 wpmThorough understanding of the revenue cycle process, from patient access (authorization, admissions) through Patient Financial Services (billing, insurance appeals, collections) procedures and policiesIntermediate skill in Microsoft Office (Word, Excel)Ability to learn hospital systems – ACE, VI Web, IMaCS, OnDemand quickly and fluentlyAbility to communicate in a clear and professional mannerMust have good oral and written skillsStrong interpersonal skillsAbove average analytical and critical thinking skillsAbility to make sound decisionsHas a 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 payorsFamiliar with terms such as HMO, PPO, IPA and Capitation and how these payors process claims.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.Benefits: Medical, dental, vision, disability, and life insurancePaid 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 match10 paid holidays per yearHealth savings accounts, healthcare & dependent flexible spending accountsEmployee Assistance program, Employee discount programVoluntary 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.