Patient Account Representative - Remote

Employer
Conifer Health Solutions
Location
Washington, DC
Posted
Jan 17, 2022
Closes
Jan 19, 2022
Ref
317831890
Function
Accountant
Industry
Healthcare
Hours
Full Time
As a part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions nationwide. We help our clients strengthen their financial and clinical performance, serve their communities and succeed at the business of healthcare. Conifer Health helps organizations transition from volume to value-based care, enhance the consumer and patient healthcare experience and improve quality, cost and access to healthcare. Are you ready to be part of our solutions? Welcome to the company that gives you the resources and incentives to redefine healthcare services, with a competitive benefits package and leadership to take your career to the next step!Job SummaryThe Patient Account Representative is responsible for working accounts to ensure they are resolved in a timely manner. This candidate should have a solid understanding of the Revenue Cycle as it relates to the entire life of a patient account from creation to payment. Representative will need to effectively follow-up on claim submission, remittance review for insurance collections, create and pursue disputed balances from both government and non-government entities. Basic knowledge of Commercial, Managed Care, Medicare and Medicaid insurance is preferable. An effective revenue cycle process is achieved with working as part of a dynamic team and the ability to adapt and grow in an environment where work assignments may change frequently while resolving accounts with minimal assistance.Team Member Should Possess The The FollowingRepresentative must be able to work independently as well as work closely with management and team to take appropriate steps to resolve an account.Perform duties as assigned in a professional demeanor, which includes interacting with insurance plans, patients, physicians, attorneys and team members as needed. Basic computer skills to navigate through the various system applications provided for additional resources in determining account actionsAccess payer websites and discern pertinent data to resolve accountsUtilize all available job aids provided for appropriateness in Patient Accounting processesDocument clear and concise notes in the patient accounting system regarding claim status and any actions taken on an accountMaintain department daily productivity goals in completing a set number of accounts while also meeting quality standards as determined by leadershipIdentify and communicate any issues including system access, payor behavior, account work-flow inconsistencies or any other insurance collection opportunitiesProvide support for team members that may be absent or backloggedEssential Duties And ResponsibilitiesInclude the following. Others may be assigned.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.QualificationsConifer requires its candidates, as applicable and as permitted by law, to obtain and provide confirmation of all required vaccinations and screenings prior to the start of employment activity. This may include, but is not limited to, the COVID-19 vaccination, influenza vaccination, and/or any future required vaccines and screenings.Knowledge, Skills, AbilitiesTo perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.Thorough 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 skills Ability 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.Education / ExperienceInclude minimum education, technical training, and/or experience preferred to perform the job.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 wpmPHYSICAL DEMANDS The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.Office/Team Work EnvironmentAbility to sit and work at a computer terminal for extended periods of timeWORK ENVIRONMENT The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.Call Center environment with multiple workstations in close proximityJob: Conifer Health SolutionsPrimary Location: Frisco, TexasJob Type: PT2NShift Type: Days