West Suburban Medical Center Patient Account Rep- Frisco NIC in Frisco, Texas
Patient Account Rep- Frisco NIC (Job Number: 1605047340)
Conifer Health Solutions is a leading healthcare business process management services provider working to improve operational performance for more than 600 clients so they can support financial improvement, enhance the patient experience, and drive value-based performance. Through our revenue cycle management, patient communications, and value-based care solutions, we empower healthcare decision makers—hospitals, health systems, physicians, self-insured employers, and payers—to better connect every point of care and wellness management. Are you ready to be part of our solutions? Welcome to the company that gives you the resources and incentives to redefine healthcare services, with a competitive benefits package and leadership to take your career to the next step!
- 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.
KNOWLEDGE, SKILLS, ABILITIES
- Very good written and verbal communication skills
- Strong interpersonal skills
- Advanced technical skills including PC and MS Outlook
- Advanced knowledge of UB-04 and Explanation of Benefits (EOB) interpretation
- Advanced knowledge of CPT and ICD-9 codes
- Advanced knowledge of insurance billing, collections and insurance terminology
EDUCATION / EXPERIENCE
- High school diploma or equivalent education
- 3-6 years experience in Medical/Hospital Insurance related collections
- Office/Team Work Environment
Primary Location: TX-Frisco
Organization: 238-Conifer - Frisco, TX