Patient Account Rep

Company Description

Conifer Health has been providing managed services to health systems, their health plans and managed populations for more than 30 years. Our value-based solutions enhance consumer engagement, drive clinical alignment, manage risk, and improve financial performance.

Our purpose of providing the foundation for better health fuels our clients to meet the unique needs of the communities they serve. 

Job Description

Essential Duties and Responsibilities:

• Responsible for all aspects of insurance follow up and collections, including making telephone calls, accessing payer websites. 
• May maintain a large dollar inventory desk as well as serve as just-in-time staffing, working inventory for team members that may be absent or backlogged. 
• Effectively resolve complex or aged inventory, including payment research, payment recoups with minimal or no assistance necessary. 
• Accurately and thoroughly document 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. 
• Proactively identify issues or trending and provide suggestions for resolution. 
• Provide assistance, coaching and training to staff members, including new hires. 
• Provide enhanced training and assist staff with techniques to increase production, quality and collections.  Participate in the new hire peer interviewing process. 
• Assist in special projects assigned by management.
• Participate and attend meetings, training seminars and in-services to develop job knowledge.  Attend various conference calls, webinars or advanced training to provide assistance to the team members. 
• Respond timely to emails and telephone messages from the staff, management and the client. 
• Effectively communicate issues to management, including payer, system or escalated account issues as well as develop solutions.

Qualifications

Minimum Education/Licensures/Qualifications:

• HS/Diploma GED equivalent
• 1+ years of Medical Insurance collections (Hospital highly preferred) 
• Must have strong follow up experience
• Follow Up service is designed to increase Revenue Collection for Hospitals and Physician offices.  The process begins after the Doctor’s biller creates and sends Health Insurance Claims (Electronic/ Paper claims or Manual HCFA forms) to various Insurance companies.  Depending on the transmission type and length of time since submission we begin our follow-up:

Electronic Claims:  Follow-Up begins 10+ days after submission

Paper/HCFA Claims:   Follow-Up begins 20-45 days after submission

Additional Information

Advantages of this Opportunity:

• Competitive salary, negotiable based on relevant experience
• Benefits offered, Medical, Dental, and Vision
• Fun and positive work environment
• Monday-Friday must be available from 8:00AM to 5:00PM hour shift.