As a part of the Tenet and Catholic Health Initiatives family, Conifer Health Solutions is a leading healthcare business process management services provider working to improve operational performance for more than 600 clients so they can support financial improvement, enhance the patient experience, and drive value-based performance. Through our revenue cycle management, patient communications, and value-based care solutions, we empower healthcare decision makers—hospitals, health systems, physicians, self-insured employers, and payers—to better connect every point of care and wellness management. 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!
Conifer Health Solutions is currently hiring for a Senior Patient Account Representative.
Responsible for all aspects of billing, follow up and collection activity. Billing responsibilities include manual re-bills as well as electronic submission to payers. Follow-up includes telephone calls to payers and/or patients, as well as accessing payer websites, and resolving complex accounts with minimal or no assistance necessary. Participate and attend meetings, training seminars and in-services to develop job knowledge. Respond timely to emails and telephone messages as appropriate. Identify, communicate and effectively work to resolve issues including payer, system or escalated account issues. Participate and assist in special projects as well as provide A/R support to the team. Assist new or existing staff with training or techniques to increase production and quality as well as provide A/R support for the team members that may be absent or backlogged.
ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned.
· Responsible for all aspects of insurance follow up and collections, including making telephone calls, accessing payer websites and filing appeals. Effectively resolves complex or aged inventory, including payment research and payment recoups with minimal or no assistance necessary. Identify issues or trending and provide suggestions for resolution. Accurately and thoroughly documents the pertinent collection activity performed. Review the account information and necessary system applications to determine the next appropriate work activity. Verify claims adjudication utilizing appropriate resources and applications. Initiate telephone or letter contact to patients to obtain additional information as needed. Perform appropriate billing functions, including manual re-bills as well as electronic submission to payers. Edit claims to meet and satisfy billing compliance guidelines for electronic submission. Manage and maintain desk inventory, complete reports, and resolve high priority and aged inventory.
· Participate and attend meetings, training seminars and in-services to develop job knowledge. Participate in the monthly, quarterly and annual performance evaluation process with their Supervisor. Respond timely to emails and telephone messages as appropriate. Identify and communicate issues to management, including payer, system or escalated account issues as well as assist in the development of solutions. Assist with special projects assigned by management as needed. Assist new or existing staff with training or techniques to increase production and quality as well as provide A/R support for the team or team members that may be absent or backlogged.
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.
- Good written and verbal communication skills
- Intermediate technical skills including PC and MS Outlook
- Advanced knowledge of UB-04 and Explanation of Benefits (EOB) interpretation
- Intermediate knowledge of CPT and ICD-9 codes
- Advanced knowledge of insurance billing, collections and insurance terminology
EDUCATION / EXPERIENCE
Include minimum education, technical training, and/or experience required to perform the job.
- High school diploma or equivalent education
- 2-5 years’ experience in Medical/Hospital Insurance related collections
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.
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.
- Office/Team Work Environment
If Other Shift, Specify:
Need to verify hours