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Patient Account Representative
Tenet HealthcarePatient account representative resolving healthcare claims and collections for Conifer Health. Researching accounts, correcting billing issues, and pursuing timely payment.
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in medical claims processing, hospital collections, and revenue cycle management, with a strong understanding of Managed Care and government payor requirements. Proficient in utilizing patient accounting applications and Microsoft Office to ensure timely resolution of patient accounts and compliance with relevant regulations.
Highest-signal resume keywords
Medical Claims ProcessingRevenue Cycle ManagementManaged Care KnowledgePatient Accounting ApplicationsAnalytical Skills
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Hospital CollectionsTyping Speed 45 WPMEOB UnderstandingUB04 Billing Form RequirementsHCFA 1500 Forms Familiarity
Soft Skills
Clear CommunicationInterpersonal SkillsCritical ThinkingProblem SolvingDecision Making
Tools & Technologies
Microsoft OfficeACEVI WebIMaCSOnDemand
Industry Keywords
Managed CareMedicareMedicaidHMOPPOIPACapitationClaims ProcessingFederal RegulationsState Regulations
About the role
Key responsibilities & impact- Work patient accounts to ensure timely resolution
- Follow up on claim submissions and review remittances for insurance collections
- Create and pursue disputed balances from government and non-government entities
- Interact with insurance plans, patients, physicians, attorneys, and team members
- Use patient accounting applications, internet resources, and payer websites to research accounts
- Contact third-party payors and/or patients by phone, email, or online regarding uncollected balances
- Update plan IDs and patient or payor demographic/insurance information
- Document claim status and account actions in the patient accounting system
- Identify payor issues and trends, solve recoup issues, and request additional documentation
- Review contracts and identify billing or coding issues; request re-bills, secondary billing, or corrected bills
- Resolve accounts timely or open dispute records for further research
- Maintain desk inventory without backlog while meeting productivity and quality standards
- Identify payment delays and aged-account trends; escalate issues to the Supervisor
- Support team members who are absent or backlogged
- Perform special projects and other assigned duties
- Attend meetings, training seminars, and in-services
- Respond timely to emails and telephone messages
- Ensure compliance with State and Federal laws and regulations for Managed Care and other Third Party Payors
Requirements
What you’ll need- High School diploma or equivalent
- 1-4 years medical claims and/or hospital collections experience
- Minimum typing requirement of 45 wpm
- Thorough understanding of the revenue cycle process, from patient access through Patient Financial Services procedures and policies
- Intermediate skill in Microsoft Office (Word, Excel)
- Ability to learn hospital systems – ACE, VI Web, IMaCS, OnDemand quickly and fluently
- Clear and professional communication; good oral and written skills
- Strong interpersonal skills
- Above average analytical and critical thinking skills
- Ability to make sound decisions
- Full 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 claims processing
- Intermediate understanding of EOB
- Intermediate understanding of hospital billing form requirements (UB04) and familiarity with HCFA 1500 forms
- Ability to problem solve, prioritize duties, and follow through completely with assigned tasks
- Required vaccinations and screenings, as applicable and permitted by law, prior to employment start
Benefits
Comp & perks- Position may be eligible for a signing bonus for qualified new hires, subject to employment status
- Conifer observed holidays receive time and a half
- Medical, dental, vision, disability, and life insurance
- Paid time off (vacation & sick leave) – min of 12 days per year
- 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, paid leave in accordance with Colorado’s Healthy Families and Workplaces Act