Patient Account Rep - Contract - Remote
Conifer Health Solutions, Frisco, TX, United States
Job Summary
The Patient Account Representative is responsible for working patient accounts to ensure they are resolved in a timely manner. The candidate should have a solid understanding of the Revenue Cycle from account creation to payment, follow up on claim submission, review remittance for insurance collections, and pursue disputed balances with both government and non‑government entities. A basic knowledge of Commercial, Managed Care, Medicare, and Medicaid insurance is preferable. Success requires working as part of a dynamic team and the ability to adapt to changing work assignments while resolving accounts with minimal assistance.
Key Responsibilities
Perform duties as assigned in a professional manner, interacting with insurance plans, patients, physicians, attorneys, and team members as needed.
Use basic computer skills to navigate system applications for account actions.
Access payer websites and discern pertinent data to resolve accounts.
Utilize all available job aids for patient accounting processes.
Document clear and concise notes in the patient accounting system regarding claim status and any actions taken.
Maintain department daily productivity goals while meeting quality standards.
Identify and communicate any issues including system access, payer behavior, account workflow inconsistencies, or insurance collection opportunities.
Provide support to team members who may be absent or backlogged.
Research each account using patient accounting applications and internet resources, contacting third‑party payors and/or patients via phone, e‑mail, or online to resolve balances and eliminate re‑work.
Update plan IDs, adjust patient or payer demographics, and notate account details, identifying payer issues and trends.
Request additional information from patients, medical records, and payors as needed.
Review contracts to identify billing or coding issues; re‑bill, secondary bill, or correct billing as required.
Take action to bring about timely account resolution or open a dispute record for further research.
Maintain desk inventory to avoid backlog while achieving productivity and quality standards.
Perform special projects and other duties as assigned; document findings and communicate results.
Recognize potential delays and trends with payors and respond to avoid A/R aging; escalating payment delays to supervisors.
Attend meetings, training seminars, and in‑services to develop job knowledge.
Respond timely to emails and telephone messages.
Ensure compliance with state and federal regulations for managed care and third‑party payors.
Knowledge, Skills & Abilities
Thorough understanding of the revenue cycle process from patient access, billing, insurance appeals, and collections procedures and policies.
Intermediate skill in Microsoft Office (Word, Excel).
Ability to learn hospital systems quickly (ACE, VI Web, IMaCS, OnDemand).
Clear, professional communication skills, both oral and written.
Strong interpersonal skills.
Above‑average analytical and critical thinking skills.
Sound decision‑making ability.
Full understanding of Commercial, Managed Care, Medicare, and Medicaid collections, including contract language and federal and state requirements for government payors.
Familiarity with HMO, PPO, IPA, and capitation payer processes.
Intermediate knowledge of EOB.
Intermediate understanding of hospital billing forms (UB04) and familiarity with HCFA 1500 forms.
Ability to problem‑solve, prioritize duties, and follow‑through completely with assigned tasks.
Education & Experience
High School diploma or equivalent; bachelor or college coursework in business administration or accounting preferred.
1–4 years of medical claims and/or hospital collections experience.
Minimum typing speed of 45 words per minute.
Physical Demands
Office / team work environment.
Ability to sit and work at a computer terminal for extended periods.
Work Environment
Call center environment with multiple workstations in close proximity.
Compensation
Pay: $15.80 – $23.70 hourly, depending on location, qualifications, and experience.
Position may be eligible for a signing bonus for qualified new hires subject to employment status.
Conifer observed holidays receive time and a half.
Benefits
Medical, dental, vision, disability, and life insurance.
Paid time off (vacation & sick leave): at least 12 days per year, accruing at 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: 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.
Employment practices will not be influenced or affected by an applicant’s or employee’s 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.
Tenet participates in the E‑Verify program.
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Key Responsibilities
Perform duties as assigned in a professional manner, interacting with insurance plans, patients, physicians, attorneys, and team members as needed.
Use basic computer skills to navigate system applications for account actions.
Access payer websites and discern pertinent data to resolve accounts.
Utilize all available job aids for patient accounting processes.
Document clear and concise notes in the patient accounting system regarding claim status and any actions taken.
Maintain department daily productivity goals while meeting quality standards.
Identify and communicate any issues including system access, payer behavior, account workflow inconsistencies, or insurance collection opportunities.
Provide support to team members who may be absent or backlogged.
Research each account using patient accounting applications and internet resources, contacting third‑party payors and/or patients via phone, e‑mail, or online to resolve balances and eliminate re‑work.
Update plan IDs, adjust patient or payer demographics, and notate account details, identifying payer issues and trends.
Request additional information from patients, medical records, and payors as needed.
Review contracts to identify billing or coding issues; re‑bill, secondary bill, or correct billing as required.
Take action to bring about timely account resolution or open a dispute record for further research.
Maintain desk inventory to avoid backlog while achieving productivity and quality standards.
Perform special projects and other duties as assigned; document findings and communicate results.
Recognize potential delays and trends with payors and respond to avoid A/R aging; escalating payment delays to supervisors.
Attend meetings, training seminars, and in‑services to develop job knowledge.
Respond timely to emails and telephone messages.
Ensure compliance with state and federal regulations for managed care and third‑party payors.
Knowledge, Skills & Abilities
Thorough understanding of the revenue cycle process from patient access, billing, insurance appeals, and collections procedures and policies.
Intermediate skill in Microsoft Office (Word, Excel).
Ability to learn hospital systems quickly (ACE, VI Web, IMaCS, OnDemand).
Clear, professional communication skills, both oral and written.
Strong interpersonal skills.
Above‑average analytical and critical thinking skills.
Sound decision‑making ability.
Full understanding of Commercial, Managed Care, Medicare, and Medicaid collections, including contract language and federal and state requirements for government payors.
Familiarity with HMO, PPO, IPA, and capitation payer processes.
Intermediate knowledge of EOB.
Intermediate understanding of hospital billing forms (UB04) and familiarity with HCFA 1500 forms.
Ability to problem‑solve, prioritize duties, and follow‑through completely with assigned tasks.
Education & Experience
High School diploma or equivalent; bachelor or college coursework in business administration or accounting preferred.
1–4 years of medical claims and/or hospital collections experience.
Minimum typing speed of 45 words per minute.
Physical Demands
Office / team work environment.
Ability to sit and work at a computer terminal for extended periods.
Work Environment
Call center environment with multiple workstations in close proximity.
Compensation
Pay: $15.80 – $23.70 hourly, depending on location, qualifications, and experience.
Position may be eligible for a signing bonus for qualified new hires subject to employment status.
Conifer observed holidays receive time and a half.
Benefits
Medical, dental, vision, disability, and life insurance.
Paid time off (vacation & sick leave): at least 12 days per year, accruing at 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: 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.
Employment practices will not be influenced or affected by an applicant’s or employee’s 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.
Tenet participates in the E‑Verify program.
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