Remote- Medical Collections Representative

Overview

Remote
- Medical Collections Representative role at Conifer Health Solutions. 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.

• Perform duties as assigned in a professional demeanor, including interacting with insurance plans, patients, physicians, attorneys and team members as needed.
• Use basic computer skills to navigate system applications for resources in determining account actions.
• Access payer websites and discern pertinent data to resolve accounts.
• Utilize all available job aids for appropriateness in Patient Accounting processes.
• Document clear and concise notes in the patient accounting system regarding claim status and actions taken on an account.
• Maintain department daily productivity goals while meeting quality standards as determined by leadership.
• Identify and communicate issues such as system access, payor behavior, workflow inconsistencies or other insurance collection opportunities.
• Provide support for team members that may be absent or backlogged.

• Researches each account using company patient accounting applications and internet resources; conducts appropriate account activity on uncollected balances; contacts third party payors and/or patients via phone, e-mail, or online; problem solves issues and creates resolutions that bring in revenue while eliminating re-work; reviews contracts to identify billing or coding issues and requests re-bills or corrected bills as needed; takes action to bring about account resolution timely or opens a dispute record for further research;
  
  maintains desk inventory to prevent backlog while achieving productivity and quality standards.
• Performs special projects as needed, documents findings, and communicates results.
• Recognizes potential delays with payors and responds to avoid A/R aging; escalates payment delays to Supervisor as appropriate.
• Participates in meetings, training seminars and in-services to develop job knowledge; responds timely to emails and telephone messages.
• Ensures compliance with State and Federal laws and regulations for Managed Care and other Third Party Payors.

• Thorough understanding of the revenue cycle process from patient access through Patient Financial Services.
• Intermediate skill in Microsoft Office (Word, Excel).
• Ability to learn hospital systems quickly and fluently.
• Clear and professional communication; strong oral and written skills; strong interpersonal skills.
• Analytical and critical thinking abilities; able to make sound decisions.
• Understanding of Commercial, Managed Care, Medicare and Medicaid collections; knowledge of Managed Care contracts, contract language and government payor requirements.
• Familiar with terms such as HMO, PPO, IPA and Capitation.
• Understanding of EOB and hospital billing form requirements (UB04) and familiarity with HCFA 1500 forms.
• Ability to problem solve, prioritize duties and follow through on tasks.

• High School diploma or equivalent. Some college coursework in business administration or accounting preferred.
• 1-4 years of medical claims and/or hospital collections experience.
• Minimum typing requirement of 45 wpm.

• Office/Team work environment.
• Ability to sit and work at a computer terminal for extended periods.

• Call Center environment with multiple workstations in close proximity.

Conifer requires its candidates, as applicable and as permitted by law, to obtain and provide confirmation of all required vaccinations and screenings prior to the start of employment. This may include, but is not limited to, the COVID-19 vaccination, influenza vaccination, and/or any future required vaccines and screenings.

• 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:
  Medical, dental, vision, disability, and life insurance;
  Paid time off; 401k with employer match; 10 paid holidays per year;
  Health savings accounts and flexible spending accounts;
  Employee Assistance and discount programs;
  Voluntary benefits;
  Colorado paid leave per Healthy…