JOB SUMMARY The Patient Account Representative is responsible for working accounts to ensure they are resolved in a timely manner. This candidate should have a solid understanding of the Revenue Cycle as it relates to the entire life of a patient account from creation to payment. Representative will need to effectively follow-up on claim submission, remittance review for insurance collections, create and pursue disputed balances from both government and non-government entities. Basic knowledge of Commercial, Managed Care, Medicare and Medicaid insurance is preferable. An effective revenue cycle process is achieved with working as part of a dynamic team and the ability to adapt and grow in an environment where work assignments may change frequently while resolving accounts with minimal assistance. Representative must be able to work independently as well as work closely with management and team to take appropriate steps to resolve an account. Team member should possess the following: - Perform duties as assigned in a professional demeanor, which includes interacting with insurance plans, patients, physicians, attorneys and team members as needed. - Basic computer skills to navigate through the various system applications provided for additional resources in determining account actions - Access payer websites and discern pertinent data to resolve accounts - Utilize all available job aids provided for appropriateness in Patient Accounting processes - Document clear and concise notes in the patient accounting system regarding claim status and any actions taken on an account - Maintain department daily productivity goals in completing a set number of accounts while also meeting quality standards as determined by leadership - Identify and communicate any issues including system access, payor behavior, account work-flow inconsistencies or any other insurance collection opportunities - Provide support for team members that may be absent or backlogged ESSENTIAL DUTIES AND RESPONSIBILITIES Include the following. Others may be assigned. - Researches each account using company patient accounting applications and internet resources that are made available. Conducts appropriate account activity on uncollected account balances with contacting third party payors and/or patients via phone, e-mail, or online. Problem solves issues and creates resolution that will bring in revenue eliminating re-work. Updates plan IDs, adjusts patient or payor demographic/insurance information, notates account in detail, identifies payor issues and trends and solves re-coup issues. Requests additional information from patients, medical records, and other needed documentation upon request from payors. Reviews contracts and identify billing or coding issues and request re-bills, secondary billing, or corrected bills as needed. Takes appropriate action to bring about account resolution timely or opens a dispute record to have the account further researched and substantiated for continued collection. Maintains desk inventory to remain current without backlog while achieving productivity and quality standards. - Perform special projects and other duties as needed. Assists with special projects as assigned, documents, findings, and communicates results. - Recognizes potential delays and trends with payors such as corrective actions and responds to avoid A/R aging. Escalates payment delays/ problem aged account timely to Supervisor. - Participate and attend meetings, training seminars and in-services to develop job knowledge. - Respond timely to emails and telephone messages as appropriate. - Ensures compliance with State and Federal Laws Regulations for Managed Care and other Third Party Payors. Conifer requires its candidates, as applicable and as permitted by law, to obtain and provide confirmation of all required vaccinations and screenings prior to the start of employment. This may include, but is not limited to, the COVID-19 vaccination, influenza vaccination, and/or any future required vaccines and screenings. KNOWLEDGE, SKILLS, ABILITIES To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. - Thorough understanding of the revenue cycle process, from patient access (authorization, admissions) through Patient Financial Services (billing, insurance appeals, collections) procedures and policies - Intermediate skill in Microsoft Office (Word, Excel) - Ability to learn hospital systems – ACE, VI Web, IMaCS, OnDemand quickly and fluently - 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 - Has a full understanding of the 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 terms such as HMO, PPO, IPA and Capitation and how these payors process claims. - Intermediate understanding of EOB. - Intermediate understanding of Hospital billing form requirements (UB04) and familiar with the HCFA 1500 forms. - Ability to problem solve, prioritize duties and follow-through completely with assigned tasks. EDUCATION / EXPERIENCE Include minimum education, technical training, and/or experience preferred to perform the job. - High School diploma or equivalent. Some college coursework in business administration or accounting preferred - 1-4 years medical claims and/or hospital collections experience - Minimum typing requirement of 45 wpm PHYSICAL DEMANDS The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. - Office/Team Work Environment - Ability to sit and work at a computer terminal for extended periods of time WORK ENVIRONMENT The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. - Call Center environment with multiple workstations in close proximity As a part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions nationwide. We help our clients strengthen their financial and clinical performance, serve their communities and succeed at the business of healthcare. Conifer Health helps organizations transition from volume to value-based care, enhance the consumer and patient healthcare experience and improve quality, cost and access to healthcare. 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! Compensation and Benefit Information Compensation - Pay: $15.80 - $23.70 per hour. Compensation depends on location, qualifications, and experience. - Position may be eligible for a signing bonus for qualified new hires, subject to employment status. - Conifer observed holidays receive time and a half. Benefits Conifer offers the following benefits, subject to employment status: - 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.

• Manage billing within the practice management system, focusing on working draft invoices and resolving rejections. • Perform final reviews for duplicate claims and manage the accurate export of billing data. • Handle Remote Patient Monitoring (RPM) submissions to ensure timely reimbursement. • Review billing data for completeness and accuracy and ensure all provider notes are signed. • Call insurance companies to verify eligibility and benefits for new leads, utilizing portals such as OneSource and Availity. • Activate new accounts in the patient account management system for membership switches. • Review and collect patient balances in the practice management system. • Identify cases requiring authorization, compile medical records, and submit requests via portal or fax. • Process payments and refunds and inform patients of overdue balances. • Focus on account escalations, working large balances, and clearing payer blockers to ensure consistent cash flow. • Review and complete auto-posted payments in the practice management system, ensuring SFTP remit files and EOBs are properly reconciled daily.

As a Remote Medical Collections Specialist at Community Health Systems (CHS) - Shared Services Center, you’ll play a vital role in quality healthcare, building enduring relationships with our patients, and providing value for the people and communities we serve. Our team members enjoy a robust benefits package including: - Paid Time Off (PTO) - Comprehensive Health Benefits - Medical, Dental & Vision - 401k with company match - Tuition reimbursement The Remote Collections Specialist is responsible for processing, reviewing, and verifying reimbursement claims to ensure accuracy, compliance, and timely resolution. This role involves analyzing account balances, identifying discrepancies, and applying appropriate transaction codes to facilitate accurate claims processing. The Reimbursement Specialist I collaborates with internal teams to support workflow efficiency, revenue integrity, and compliance with payer guidelines while maintaining productivity and accuracy standards. - Processes and verifies reimbursement claims, ensuring accuracy and compliance with payer guidelines and regulatory requirements. - Reviews and resolves claim discrepancies, identifying incorrect payments, denials, or underpayments and taking appropriate action. - Applies correct transaction codes to accounts, ensuring proper claim adjudication and reimbursement flow. - Monitors and follows up on outstanding claims, ensuring timely resolution and payment collection. - Collaborates with revenue cycle teams and payers to investigate claim denials and appeal decisions when necessary. - Researches and interprets payer policies, ensuring adherence to reimbursement requirements and claim submission rules. - Documents account actions accurately and thoroughly in the appropriate systems, maintaining compliance with department protocols. - Identifies process improvement opportunities, contributing to increased efficiency and streamlined reimbursement workflows. - Maintains strict confidentiality of patient and financial information, ensuring compliance with HIPAA and corporate policies. - Performs other duties as assigned. - Complies with all policies and standards. - This is a fully remote opportunity. Qualifications - H.S. Diploma or GED required - Associate Degree or coursework in Accounting, Finance, Healthcare Administration, or related field preferred - 0-1 years of experience in medical billing, reimbursement, claims processing, or accounts receivable required - Experience with payer reimbursement policies, claim adjudication, and healthcare revenue cycle operations preferred Knowledge, Skills and Abilities - Strong knowledge of medical billing, reimbursement procedures, and payer guidelines. - Familiarity with claim submission, denial management, and appeals processes. - Ability to analyze account balances, identify discrepancies, and apply appropriate adjustments. - Proficiency in electronic health records (EHR), billing software, and reimbursement systems. - Strong problem-solving and critical-thinking skills, ensuring accurate claims resolution. - Effective communication and collaboration skills, working with payers, revenue cycle teams, and internal departments. - Knowledge of HIPAA, compliance regulations, and healthcare reimbursement standards. We know it’s not just about finding a job. It’s about finding a place where you are respected, valued and where your work is purposeful and fulfilling. A place where your talent is recognized, professional development is encouraged and career advancement is possible. Community Health Systems is one of the nation's leading healthcare providers. With healthcare delivery systems in 36 distinct markets across 14 states, CHS operates 69 affiliated hospitals with more than 10,000 beds and approximately 1,000 other sites of care, including physician practices, urgent care centers, freestanding emergency departments, imaging centers, cancer centers, and ambulatory surgery centers. This position is not eligible for immigration sponsorship now or in the future. Applicants must be authorized to work in the U.S. for any employer.

Job Summary The Underpayment & Overpayment Collector – Healthcare (REMOTE) is responsible for the timely and efficient resolution of underpaid and overpaid accounts. This role involves managing account follow-up, analyzing trends, collaborating with internal departments, and ensuring accurate reconciliation of account balances. The PCCM Collector assists in optimizing revenue cycle processes and maintaining compliance with contractual agreements. As a Payment Compliance Collector at Community Health Systems (CHS) - PCCM, you’ll play a vital role in supporting our purpose to help people get well and live healthier by providing safe, quality healthcare, building enduring relationships with our patients, and providing value for the people and communities we serve. Our team members enjoy a robust benefits package including medical, dental and vision, insurance, and 401k. Essential Functions - Manages account follow-up for underpaid and overpaid claims, escalating unresolved issues internally as needed to achieve resolution. - Reconciles account balances and adjustments to ensure accurate financial status and compliance with contractual terms. - Resolves underpayments by engaging in daily communication with payers and negotiating payment discrepancies. - Identifies and analyzes trends in underpayments, overpayments, denials, and revenue opportunities to recommend process improvements. - Evaluates and interprets contract reimbursement details, providing feedback and insights to the department to enhance revenue cycle performance. - Collaborates with financial and clinical departments to address account discrepancies and ensure effective revenue management. - Reviews contract validation, updates, and provides interpretation to support accurate claim processing and collections. - Ensures thorough and accurate validation of account analysis before distribution, maintaining compliance with policies and procedures. - Performs other duties as assigned. - Complies with all policies and standards. - This is a fully remote position Qualifications - H.S. Diploma or GED required - Associate Degree or higher preferred - 1-2 years of experience in healthcare collections, revenue cycle, or contract management required - Familiarity with payer contracts and healthcare reimbursement methodologies preferred - Experience in hospital insurance collections strongly preferred - UB-O4 experience strongly preferred Knowledge, Skills and Abilities - Strong analytical and problem-solving skills. - Proficient in understanding and interpreting payer contracts and reimbursement terms. - Effective communication and negotiation skills. - Ability to work independently and manage multiple priorities in a fast-paced environment. - Proficiency in healthcare billing software, Google Suite, and Microsoft Office Suite, especially Excel. - Attention to detail and high degree of accuracy in reconciliation and analysis. We know it’s not just about finding a job. It’s about finding a place where you are respected, valued and where your work is purposeful and fulfilling. A place where your talent is recognized, professional development is encouraged and career advancement is possible. The Payment Compliance and Contract Management (PCCM) team plays a critical role in ensuring that payments are made according to contractual agreements and regulatory requirements. The team oversees the full contract lifecycle, focusing on analyzing reimbursement discrepancies, improving revenue cycle processes, and ensuring compliance with contract terms to support financial accuracy and operational efficiency. Community Health Systems is one of the nation's leading healthcare providers. With healthcare delivery systems in 36 distinct markets across 14 states, CHS operates 69 affiliated hospitals with more than 10,000 beds and approximately 1,000 other sites of care, including physician practices, urgent care centers, freestanding emergency departments, imaging centers, cancer centers, and ambulatory surgery centers.