Patient Account Representative

Job Summary

The Patient Account Representative is responsible for managing patient accounts to ensure timely resolution. The role requires a solid understanding of the revenue cycle from account creation to payment, effective follow‑up on claim submissions, remittance reviews, and pursuit of disputed balances from government and non‑government payers. Basic knowledge of Commercial, Managed Care, Medicare and Medicaid insurance is preferred. Success depends on strong teamwork, adaptability, and the ability to independently resolve accounts in a fast‑changing environment.

• Interact professionally with insurance plans, patients, physicians, attorneys, and team members.
• Navigate various system applications and payer websites to gather data and resolve accounts.
• Utilize job aids for patient accounting processes and document clear, concise notes in the system.
• Meet daily productivity goals while maintaining quality standards.
• Identify, communicate, and resolve issues such as system access, payer behavior, and workflow inconsistencies.
• Support teammates who may be absent or backlogged.

• Research each account using company applications and internet resources; contact third‑party payors and patients via phone, email, or to collect uncollected balances.
• Problem‑solve issues and create revenue‑generating resolutions, eliminate re‑work, and adjust account information as needed.
• Request additional documentation from patients, medical records, or payors and review contracts for billing or coding issues.
• Open dispute records when necessary and pursue continued collection.
• Assist with special projects and document findings.
• Avoid A/R aging by recognizing payor delays and escalating issues to supervisors promptly.
• Participate in meetings, training seminars, and in‑services to develop job knowledge.
• Respond timely to and telephone messages.
• Ensure compliance with State and Federal Laws and regulations for Managed Care and other third‑party payors.

• Comprehensive understanding of the revenue cycle from patient access to collections.
• Intermediate skill in Microsoft Office (Word, Excel).
• Fast learner of hospital systems (ACE, VI Web, IMaCS, OnDemand).
• Clear and professional communication; strong oral and written skills.
• Strong interpersonal, analytical and critical thinking skills.
• Ability to make sound decisions and prioritize duties.
• Full understanding of Commercial, Managed Care, Medicare and Medicaid collections with contractual knowledge.
• Familiar with HMO, PPO, IPA, Capitation and payor claim processing.
• Intermediate knowledge of EOB, UB‑04 billing form, and HCFA 1500 forms.
• Problem‑solving and follow‑through on assigned tasks.

• High School diploma or equivalent; some college coursework in business administration or accounting preferred.
• 1‑4 years medical claims and/or hospital collections experience.
• Typing speed of at least 45 words per minute.

• Office/Team work environment; call center with multiple workstations.
• Ability to sit and work at a computer terminal for extended periods.

• Pay: $15.80 – $23.70 per hour (location, qualifications, and experience may affect pay).
• Eligible for signing bonus for qualified new hires.
• Observed holidays receive time and a half.

• Medical, dental, vision, disability, and life insurance.
• Paid time off (vacation & sick leave) – minimum 12 days per year.
• 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.
• Optional benefits: pet insurance, legal insurance, accident and critical illness insurance, long‑term care, elder & childcare, AD&D, auto & home insurance.

Conifer Health is an equal opportunity employer. Employment decisions are made without regard to race, color, religion, sex, national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status, or any other legally protected status. Conifer complies with all applicable federal, state and local laws and makes reasonable accommodations for qualified individuals with disabilities.