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Patient Account Representative
Tenet Healthcare. Work accounts to ensure they are resolved in a timely manner .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in medical claims processing and hospital collections, with a thorough understanding of the revenue cycle and compliance with state and federal regulations. Proficient in navigating hospital systems and managing accounts while maintaining productivity and quality standards.
Highest-signal resume keywords
Medical Claims ProcessingRevenue Cycle ManagementMicrosoft Office (Word, Excel)Managed Care CollectionsEOB Understanding
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Medical Claims ExperienceHospital Collections ExperienceTyping Speed (45 WPM)Patient Accounting ApplicationsHospital Billing Form Requirements (UB04)HCFA 1500 Forms FamiliarityContract Language UnderstandingProblem SolvingAnalytical SkillsCritical Thinking
Soft Skills
Interpersonal SkillsCommunication SkillsDecision MakingPrioritizationProfessional Manner
Tools & Technologies
ACEVI WebIMaCSOnDemand
Industry Keywords
Managed CareMedicareMedicaidHMOPPOIPACapitationFederal RegulationsState RegulationsRevenue Cycle Process
About the role
Key responsibilities & impact- Work accounts to ensure they are resolved in a timely manner
- Follow up on claim submission and review remittances for insurance collections
- Create and pursue disputed balances from government and non-government entities
- Interact with insurance plans, patients, physicians, attorneys and team members
- Navigate system applications and payer websites to determine account actions
- Document clear and concise notes regarding claim status and actions taken
- Maintain daily productivity goals while meeting quality standards
- Identify and communicate system access, payer behavior, workflow, and insurance collection issues
- Provide support for absent or backlogged team members
- Research accounts using patient accounting applications and internet resources
- Contact third-party payors and patients by phone, email, or online regarding uncollected balances
- Resolve issues, update plan IDs, adjust patient or payor demographic and insurance information, and identify payor trends
- Request information and documentation from patients, medical records, and other sources
- Review contracts and identify billing or coding issues; request rebills, secondary billing, or corrected bills
- Take timely action to resolve accounts or open dispute records for further research
- Maintain desk inventory without backlog while achieving productivity and quality standards
- Perform special projects and other assigned duties
- Recognize payor delays and trends, take corrective action, and escalate aged accounts to the Supervisor
- Attend meetings, training seminars, and in-services
- Respond timely to emails and telephone messages
- Ensure compliance with state and federal laws and regulations for Managed Care and other third-party payors
Requirements
What you’ll need- High School diploma or equivalent
- 1-4 years medical claims and/or hospital collections experience
- Minimum typing requirement of 45 wpm
- 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 – ACE, VI Web, IMaCS, OnDemand quickly and fluently
- Has a 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
- Familiar with HMO, PPO, IPA and Capitation and how these payors process claims
- Intermediate understanding of EOB
- Intermediate understanding of hospital billing form requirements (UB04) and familiarity with HCFA 1500 forms
- Ability to problem solve, prioritize duties and follow through completely with assigned tasks
- Ability to communicate in a clear and professional manner
- Must have good oral and written skills
- Strong interpersonal skills
- Above average analytical and critical thinking skills
- Ability to make sound decisions
- Some college coursework in business administration or accounting preferred
- Required vaccinations and screenings, as applicable and permitted by law, prior to employment start
Benefits
Comp & perks- Position may be eligible for a signing bonus for qualified new hires, subject to employment status
- Conifer observed holidays receive time and a half
- 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
- Competitive benefits package
- Leadership to take your career to the next step