The 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.
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, 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 actions.
Access payer websites and discern pertinent data to resolve accounts.
Document clear and concise notes in the patient accounting system regarding claim status and any actions taken on an account.
Maintain department daily productivity goals in completing a set number of accounts while also meeting quality standards as determined by leadership.
Identify and communicate any issues including system access, payor behavior, account work-flow inconsistencies or any other insurance collection opportunities.
Provide support for team members that may be absent or backlogged.

High School diploma or equivalent. Some college coursework in business administration or accounting preferred
1-4 years medical claims and/or hospital collections experience
Minimum typing requirement of 45 wpm
Thorough understanding of the revenue cycle process, from patient access (authorization, admissions) through Patient Financial Services (billing, insurance appeals, collections) procedures and policies
Intermediate skill in Microsoft Office (Word, Excel)
Ability to learn hospital systems – ACE, VI Web, IMaCS, OnDemand quickly and fluently
Ability to communicate in a clear and professional manner
Must have good oral and written skills
Strong interpersonal skills
Above average analytical and critical thinking skills
Ability to make sound decisions
Has 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 payors
Familiar 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.

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.

Patient Account Representative

Key skills