Patient Account Representative-Remote

Tenet Healthcare; Frisco (TX); Remote; USD 10,000 - 60,000; Full time

Job summary

Join a forward-thinking healthcare organization as a Patient Account Representative, where you will play a crucial role in managing patient accounts through the entire revenue cycle. This dynamic position involves resolving claims, collaborating with insurance providers, and ensuring timely payments. You will thrive in a supportive team environment, adapting to changing tasks while maintaining high productivity standards. With a focus on professional growth and a commitment to quality patient care, this role offers you the chance to make a real difference in healthcare services. If you are detail-oriented, possess strong analytical skills, and are ready to take your career to the next level, this opportunity is for you.

Benefits

Medical, Dental, and Vision Insurance

Paid Time Off

401k with Employer Match

Employee Assistance Program

Voluntary Benefits

Qualifications

• Understanding of revenue cycle processes from patient access to collections.
• Experience with medical claims and hospital collections preferred.

Responsibilities

• Resolve patient accounts through effective communication with payors and patients.
• Document account actions and maintain productivity goals.

Skills

Revenue Cycle Knowledge

Microsoft Office

Analytical Skills

Communication Skills

Problem-Solving

Interpersonal Skills

Typing Speed (45 wpm)

Education

High School Diploma or Equivalent

Some College Coursework in Business Administration or Accounting

Tools

ACE

VI Web

IMaCS

OnDemand

Job description

JOB SUMMARY

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. The 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 by 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.

Representatives must be able to work independently as well as work closely with management and the team to take appropriate steps to resolve an account. Team members should possess the following:

• 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.
• Utilize all available job aids provided for appropriateness in Patient Accounting processes.
• 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 workflow inconsistencies, or any other insurance collection opportunities.
• Provide support for team members that may be absent or backlogged.

ESSENTIAL DUTIES AND RESPONSIBILITIES

Include the following. Others may be assigned.

• Research each account using company patient accounting applications and internet resources that are made available. Conduct appropriate account activity on uncollected account balances by contacting third-party payors and/or patients via phone, e-mail, or online. Problem-solve issues and create resolutions that will bring in revenue while eliminating re-work. Update plan IDs, adjust patient or payor demographic/insurance information, notate accounts in detail, identify payor issues and trends, and solve recoup issues. Request additional information from patients, medical records, and other needed documentation upon request from payors. Review contracts and identify billing or coding issues and request re-bills, secondary billing, or corrected bills as needed. Take appropriate action to bring about account resolution timely or open a dispute record to have the account further researched and substantiated for continued collection. Maintain desk inventory to remain current without backlog while achieving productivity and quality standards.
• Perform special projects and other duties as needed. Assist with special projects as assigned, document findings, and communicate results.
• Recognize potential delays and trends with payors such as corrective actions and respond to avoid A/R aging. Escalate payment delays/problem aged accounts 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.
• Ensure compliance with State and Federal Laws and Regulations for Managed Care and other Third Party Payors.

KNOWLEDGE, SKILLS, ABILITIES

To 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 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.
• 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.

EDUCATION / EXPERIENCE

Include 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 preferred.
• 1-4 years medical claims and/or hospital collections experience.
• Minimum typing requirement of 45 wpm.

PHYSICAL 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 Environment.
• Ability to sit and work at a computer terminal for extended periods of time.

WORK 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 proximity.

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!

Compensation and Benefit Information

Compensation

• 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.
• Conifer observed holidays receive time and a half.

Benefits

Conifer offers the following benefits, subject to employment status:

• 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.