Patient Analysis Rep Business Office FT Days

Conifer Health Solutions•Nacogdoches, TX

1d•Onsite

About The Position

The Patient Account Representative I performs daily tasks such as auditing patient accounts, responding to correspondence, email requests, respond to patient and payer inquiries and concerns, perform claims follow-up, and completes special projects or other related duties as assigned.

Requirements

High school diploma or equivalent
1 year of customer service and/or medical billing.

Nice To Haves

Completion of a Medical Billing or Medical Administration Assistant Program or equivalent experience.
2 years of billing and/or customer service experience in a commercial or health care environment.
Proficient in Word and Excel

Responsibilities

Responsible for sending requested CCD receipts from phone payments, printing patient statements, insurance follow up and collections, insurance follow up and collections, including making telephone calls, accessing payer websites and VI Web.
Responsible for accessing any insurance portals or platforms for claim resolution, providing 0-90+ aged claims, providing claim status aged claims 120+, determining claims that have been fully worked, determining adjustment claims, determining overpayments, deductibles & coinsurance & copays, processing claims assigned by PAR III or direct supervisor, and bringing in outstanding revenue for aged claims 121+.
Responds to inquiries on accounts as referred by other departments.
Auditing patient statements.
Audit and review account for Patient Refund.
Initiating and process the refund for patient or insurance.
Inform direct supervisor of insurance trends, contract rate changes, increase in denials, etc.
Accurately and thoroughly document the pertinent collection activity performed.
Review the account information and necessary system applications to determine the next appropriate work activity.
Review and resolve denied claims.
Review and provide requested information to health insurance for claims processing.
Review and process incoming correspondence.
Process patient/insurance phone calls.
Collect patient payment when applicable.
Manage Insurance Aging Reports.
Deescalate phone calls and provide a resolution within 24-48 hours.
Effectively resolve complex or aged inventory, including payment research, payment recoups with minimal or no assistance necessary.
Responsible for other duties deemed necessary by direct supervisors.