[Remote] Remote-Accounts Receivable Representative (Healthcare)

Note: The job is a remote job and is open to candidates in USA. Conifer Health Solutions is a company that specializes in healthcare services, focusing on enhancing financial and clinical performance. They are seeking a Patient Account Representative responsible for managing patient accounts through the revenue cycle, ensuring timely resolution of claims, and collaborating with various stakeholders to improve collections and account management. Responsibilities Researches each account using company patient accounting applications and internet resources that are made available. Conducts appropriate account activity on uncollected account balances with contacting third party payors and/or patients via phone, e-mail, or online. Problem solves issues and creates resolution that will bring in revenue eliminating re-work. Updates plan IDs, adjusts patient or payor demographic/insurance information, notates account in detail, identifies payor issues and trends and solves re-coup issues. Requests additional information from patients, medical records, and other needed documentation upon request from payors. Reviews contracts and identify billing or coding issues and request re-bills, secondary billing, or corrected bills as needed. Takes appropriate action to bring about account resolution timely or opens a dispute record to have the account further researched and substantiated for continued collection. Maintains desk inventory to remain current without backlog while achieving productivity and quality standards Perform special projects and other duties as needed. Assists with special projects as assigned, documents, findings, and communicates results Recognizes potential delays and trends with payors such as corrective actions and responds to avoid A/R aging. Escalates payment delays/ problem aged account timely to Supervisor Participate and attend meetings, training seminars and in-services to develop job knowledge Respond timely to emails and telephone messages as appropriate Ensures compliance with State and Federal Laws Regulations for Managed Care and other Third Party Payors Skills Solid understanding of the Revenue Cycle as it relates to the entire life of a patient account from creation to payment Ability to effectively follow-up on claim submission, remittance review for insurance collections Ability to create and pursue disputed balances from both government and non-government entities Basic knowledge of Commercial, Managed Care, Medicare and Medicaid insurance Ability to work independently as well as closely with management and team Professional demeanor when interacting with insurance plans, patients, physicians, attorneys and team members Basic computer skills to navigate through various system applications Ability to access payer websites and discern pertinent data to resolve accounts Ability to document clear and concise notes in the patient accounting system Ability to maintain department daily productivity goals while meeting quality standards Ability to identify and communicate any issues including system access, payor behavior, account work-flow inconsistencies Ability to provide support for team members that may be absent or backlogged Thorough understanding of the revenue cycle process, from patient access through Patient Financial Services procedures and policies Intermediate skill in Microsoft Office (Word, Excel) Ability to learn hospital systems quickly and fluently Ability to communicate in a clear and professional manner Good oral and written skills Strong interpersonal skills Above average analytical and critical thinking skills Ability to make sound decisions Full understanding of the 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 terms such as HMO, PPO, IPA and Capitation Intermediate understanding of EOB Intermediate understanding of Hospital billing form requirements (UB04) and familiar with the HCFA 1500 forms Ability to problem solve, prioritize duties and follow-through completely with assigned tasks High School diploma or equivalent 1-4 years medical claims and/or hospital collections experience Minimum typing requirement of 45 wpm Some college coursework in business administration or accounting Benefits Medical, dental, vision, disability, and life insurance Paid time off (vacation & sick leave) – min of 12 days per year, accrue at a rate of approximately 1.84 hours per 40 hours worked. 401k 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 Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, AD&D, auto & home insurance. For Colorado employees, Conifer offers paid leave in accordance with Colorado’s Healthy Families and Workplaces Act. Company Overview Conifer Health Solutions is a healthcare services company helping organizations strengthen their financial performance It was founded in 2008, and is headquartered in Frisco, Texas, USA, with a workforce of 10001+ employees. Its website is Company H1B Sponsorship Conifer Health Solutions has a track record of offering H1B sponsorships, with 5 in 2025, 3 in 2024. Please note that this does not guarantee sponsorship for this specific role.