Remote- Hospital Account Collections Representative

Job Summary The Patient Account Representative is responsible for managing patient accounts to ensure timely resolution. The candidate must have a solid understanding of the revenue cycle from account creation to payment, including claim submission, remittance review, and pursuing disputed balances from both government and non‑government entities. Basic knowledge of Commercial, Managed Care, Medicare, and Medicaid insurance is preferred. The role requires working independently and as part of a dynamic team, adapting to changing work assignments while maintaining minimal assistance. Key Responsibilities Perform duties as assigned in a professional demeanor, interacting with insurance plans, patients, physicians, attorneys, and team members as needed. Use basic computer skills to navigate system applications for account actions. Access payer websites and discern pertinent data to resolve accounts. Utilize all available job aids for patient accounting processes. Document clear and concise notes in the patient accounting system regarding claim status and actions taken. Maintain department daily productivity goals while meeting quality standards. Identify and communicate issues such as system access, payer behavior, workflow inconsistencies, or other collection opportunities. Provide support for team members who are absent or backlogged. Essential Duties and Responsibilities Research accounts using company patient accounting applications and internet resources, contacting third‑party payors and patients via phone, email, or online to perform account activity on uncollected balances. Problem‑solve issues and create revenue‑generating resolutions, eliminating re‑work and applying updates to plan IDs, patient or payer demographics, and detailed notes. Identify payer issues and trends, resolve re‑coups, and request additional information from patients, medical records, or payors as needed. Review contracts, identify billing or coding issues, and request re‑bills, secondary billing, or corrected bills. Take appropriate action to bring about timely account resolution or open a dispute record for further research. Maintain desk inventory, achieve productivity and quality standards, and perform special projects or other duties as assigned. Recognize potential delays and trends with payors, respond to avoid A/R aging, and escalates payment delays promptly to Supervisor. Attend meetings, training seminars, and in‑services to develop job knowledge; respond timely to emails and telephone messages as appropriate. Ensure compliance with state and federal laws and regulations for managed care and third‑party payors. Knowledge, Skills, and Abilities Comprehensive understanding of the revenue cycle process, from patient access to billing, appeals, and collections. Intermediate skill in Microsoft Office (Word, Excel). Ability to learn hospital systems (ACE, VI Web, IMaCS, OnDemand) quickly and fluently. Clear and professional communication skills, both oral and written. Strong interpersonal skills and above‑average analytical and critical thinking. Ability to make sound decisions and prioritize duties, following through fully. Full understanding of Commercial, Managed Care, Medicare, and Medicaid collections, including contract language and federal/state requirements. Familiarity with HMO, PPO, IPA, Capitation and how payors process claims. Intermediate understanding of EOB and hospital billing form requirements (UB‑04, HCFA‑1500). Problem‑solving and prioritization of tasks with complete follow‑through on assigned work. Education and Experience 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 speed of 45 words per minute. Physical Demands Office/Team work environment. Ability to sit and work at a computer terminal for extended periods of time. Work Environment Call center environment with multiple workstations in close proximity. Compensation Pay ranges from $15.80 to $23.70 per hour. Position may be eligible for a signing bonus for qualified new hires, subject to employment status. Observed holidays receive time and a half. Benefits Medical, dental, vision, disability, and life insurance. Paid time off (vacation & sick leave) – minimum 12 days per year, accruing at approximately 1.84 hours per 40 hours worked. 401(k) 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 including pet, legal, accident and critical illness insurance, long‑term care, elder & childcare, AD&D, auto & home insurance. For Colorado employees, paid leave in accordance with Colorado’s Healthy Families and Workplaces Act. Equal Employment Opportunity Employment practices will not be influenced or affected by an applicant’s or employee’s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status, or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship. Tenet participates in the E‑Verify program. #J-18808-Ljbffr Conifer Health Solutions