Patient Account Representative

Tenet Healthcare Corporation•Frisco, TX

7d•$16 - $24

About The Position

The Patient Account Representative works patient accounts to ensure timely resolution and supports the revenue cycle from account creation through payment. The role follows up on claim submissions, reviews remittances for insurance collections, and creates and pursues disputed balances with government and non-government payors. The representative works independently with minimal assistance while collaborating with management and teammates, adapting to changing assignments, and meeting productivity and quality standards. The role requires professional interaction with insurance plans, patients, physicians, attorneys, and colleagues; use of patient accounting applications, payer websites, and job aids; and clear documentation of claim status and account actions. The representative also identifies collection opportunities and workflow or system issues, communicates trends, and supports teammates when they are absent or backlogged. The position researches uncollected account balances, contacts payors and patients by phone, email, or online, resolves account issues, updates insurance and demographic information, requests supporting documentation, reviews contracts for billing or coding issues, and requests rebills or corrected bills as appropriate. The representative takes timely collection action or opens disputes for further research, maintains current desk inventory, escalates delayed payments or aged accounts, responds to communications, attends training and meetings, and follows applicable state and federal requirements for managed care and other third-party payors. Vaccination and screening confirmation may be required before employment, as applicable and permitted by law. The role is performed in an office/team setting within a call center, with multiple workstations in close proximity. It involves extended periods sitting and working at a computer terminal.

Requirements

High school diploma or equivalent.
1–4 years of medical claims and/or hospital collections experience.
Minimum typing speed of 45 words per minute.
Thorough understanding of the revenue cycle, from patient access through Patient Financial Services procedures and policies.
Intermediate skill in Microsoft Word and Excel.
Ability to learn hospital systems ACE, VI Web, IMaCS, and OnDemand quickly and fluently.
Clear and professional communication, with good oral and written skills.
Strong interpersonal skills.
Above-average analytical and critical-thinking skills and the ability to make sound decisions.
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.
Familiarity with HMO, PPO, IPA, and capitation terminology and how these payors process claims.
Intermediate understanding of EOBs.
Intermediate understanding of hospital billing form requirements (UB04) and familiarity with HCFA 1500 forms.
Ability to problem-solve, prioritize duties, and follow assigned tasks through to completion.
Ability to work independently and collaboratively, adapt to changing assignments, and resolve accounts with minimal assistance.
Ability to sit and work at a computer terminal for extended periods.
As applicable and permitted by law, obtain and provide confirmation of required vaccinations and screenings before employment.

Nice To Haves

Some college coursework in business administration or accounting.
Basic knowledge of Commercial, Managed Care, Medicare, and Medicaid insurance.

Responsibilities

Research accounts using patient accounting applications and available internet resources.
Contact third-party payors and/or patients by phone, email, or online regarding uncollected account balances.
Resolve account issues, update plan IDs and patient or payor demographic and insurance information, document account activity, identify payor trends, and resolve recoupment issues.
Request information and documentation from patients, medical records, or other sources when requested by payors.
Review contracts to identify billing or coding issues and request rebills, secondary billing, or corrected bills as needed.
Take appropriate action to resolve accounts promptly or open dispute records for further research and continued collection.
Maintain current desk inventory without backlog while meeting productivity and quality standards.
Complete special projects and other assigned duties, document findings, and communicate results.
Recognize payor delays and trends, take corrective action to avoid accounts receivable aging, and escalate payment delays or problem aged accounts to the Supervisor.
Attend meetings, training seminars, and in-services to develop job knowledge.
Respond promptly to emails and telephone messages as appropriate.
Ensure compliance with state and federal laws and regulations for managed care and other third-party payors.
Interact professionally with insurance plans, patients, physicians, attorneys, and team members.
Use payer websites, system applications, and job aids to determine appropriate account actions and document account status clearly.
Identify and communicate system access issues, payor behavior, workflow inconsistencies, and other insurance collection opportunities.
Support team members who are absent or backlogged.

Benefits

Medical, dental, vision, disability, and life insurance.
Paid time off for vacation and sick leave, with a minimum of 12 days per year and accrual of approximately 1.84 hours per 40 hours worked.
401(k) with up to 6% employer match.
10 paid holidays per year; Conifer-observed holidays receive time and a half.
Health savings accounts and healthcare and dependent-care 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 and childcare benefits, AD&D, and auto and home insurance.
Colorado employees receive paid leave in accordance with Colorado’s Healthy Families and Workplaces Act.
Position may be eligible for a signing bonus for qualified new hires, subject to employment status.