About Conifer Health
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 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. 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.
ESSENTIAL DUTIES AND RESPONSIBILITIES
Include the following. Others may be assigned.
- Researches each account using company patient accounting applications and internet resources
- Conducts appropriate account activity on uncollected account balances
- Contacts 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
- Maintains desk inventory to remain current without backlog while achieving productivity and quality standards
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
- 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)
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
Compensation and Benefit Information
Compensation
Pay: $14.50-$21.80 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.
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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.
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