Remote-Patient Account Representative

Job Summary
The Patient Account Representative is responsible for working accounts to ensure they are resolved in a timely manner. They must have a solid understanding of the Revenue Cycle covering the entire life of a patient account from creation to payment. The representative will follow up on claim submission, review remittances, and pursue disputed balances from both government and non‑government entities. Basic knowledge of commercial, managed care, Medicare, and Medicaid insurance is preferable.

• Perform duties as assigned with a professional demeanor, interacting with insurance plans, patients, physicians, attorneys, and team members.
• Maintain basic computer skills and navigate various system applications for account actions.
• Access payer websites and discern relevant data to resolve accounts.
• Utilize all available job aids in patient accounting processes.
• Document clear and concise notes in the patient accounting system regarding claim status and actions taken.
• Maintain departmental daily productivity goals while meeting quality standards set by leadership.
• Identify and communicate issues, including system access, payor behavior, account workflow inconsistencies, or collection opportunities.
• Provide support for team members when absent or when a backlog exists.
• Research each account using company patient accounting applications and internet resources; conduct account activity with third‑party payors and/or patients via phone, e‑mail, or online.
• Problem‑solve issues and create revenue‑generating resolutions to eliminate re‑work.
• Update plan IDs, adjust patient or payer demographic/insurance information, and notate account details thoroughly.
• Identify payer issues, trends, and recoup opportunities; take appropriate action or open a dispute record for further research.
• Request additional information from patients, medical records, or other documentation as needed by payors.
• Review contracts, identify billing or coding issues, and request re‑bills, secondary billing, or corrected bills as needed.
• Maintain desk inventory and avoid backlog while achieving productivity and quality standards.
• Perform special projects and document findings and results.
• Recognize potential delays and trends with payors, take corrective actions, and avoid A/R aging.
• Escalate payment delays or aged accounts to supervisor in a timely manner.
• Participate in meetings, training seminars, and in‑services to develop job knowledge.
• Respond promptly to emails and telephone messages as appropriate.
• Ensure 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 such as ACE, VI Web, IMaCS, OnDemand quickly.
• Ability to communicate clearly and professionally.
• Good oral and written skills.
• Strong interpersonal skills.
• Above‑average analytical and critical‑thinking skills.
• Ability to make sound decisions.
• Full understanding of commercial, managed care, Medicare, and Medicaid collections; intermediate knowledge of managed‑care contracts, contract language; and federal and state requirements for government payors.
• Familiarity with HMO, PPO, IPA, and capitation and how payors process claims.
• Intermediate understanding of EOB.
• Intermediate understanding of hospital billing form requirements (UB‑04) and familiarity with HCFA 1500 forms.
• Ability to problem‑solve, prioritize duties, and follow through completely with assigned 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 Health, part of the Tenet and Catholic Health Initiatives family, brings 30 years of healthcare…