Central Denials Account Representative – Hospital, Onsite

Guidehouse; Birmingham (AL); On-site; USD 32,000 - 45,000; Full time

Benefits offered by this job

Medical, Rx, Dental & Vision Insurance

401(k) Retirement Plan

Paid Holidays

Job summary

Guidehouse is seeking a Central Denials Account Representative in Birmingham, AL. You will conduct comprehensive account reviews, determine actions to resolve balances, and collaborate with insurance companies to resolve denials and appeals.

This role requires 0-2 years of medical billing experience and strong communication skills. Responsibilities include resubmitting corrected claims, escalating payer issues when needed, and coordinating with other departments to ensure accurate patient

Qualifications

• HS Diploma or equivalent.
• 0-2 years medical billing experience working with UB04, appeals & denials.

Responsibilities

• Conduct thorough account reviews to resolve denials and balances.
• Make outbound calls to Insurance Companies to resolve claim denials.
• Resubmit corrected claims and supporting documentation for patient experience.
• Escalate payer issues to supervisor with relevant information for resolution.
• Communicate areas of concern or improvement to management.
• Work independently with minimal supervision and initiate projects.
• Demonstrate good written and verbal communication skills.

Skills

Medical Billing

Denials Resolution

Customer Service

Communication Skills

Education

HS Diploma or equivalent

Job description

++Job Family++:
Patient Account Representative

++Travel Required++:
None

++Clearance Required++:
None ++What You Will Do++: The Central Denials Account Representative conducts thorough account reviews to determine the appropriate action needed to resolve the account balance. This includes reviewing and performing the following:

• 227 Electronic Files
• 835 Electronic Files
• UB04’s and 1500 Claim Files
• Medical Record
• Making outbound calls to Insurance Companies to resolve claim denials and account balances.
• Performing Non-Clinical Appeals.
• Assisting Supervisor/Manager as needed with various projects.
• Escalate payer issues/trends to a supervisor with the appropriate information or take appropriate action so that the issue expert can effectively resolve the matter.
• Communicate to Supervisor/Manager areas of concern or areas of improvement.
• Resubmit Corrected Claims and supporting documentation as need for the patient experience.
• Communicate with other organizational departments to ensure proper handling of patient accounts.
• Communicates issues to management timely and performs other duties as assigned by direct supervisors.
• Perform a variety of duties often changing from one task to another of a different nature without loss of efficiency or composure.
• Ability to initiate and follow through on projects and work independently with minimal supervision required.
• Good written and verbal communications skills

++What You Will Need++:

• HS Diploma or equivalent.
• 0-2 years medical billing experience working with UB04, appeals & denials.

++What Would Be Nice to Have++:

• Ability to interpret and apply reimbursement aspects of managed healthcare contracts.
• Exceptional customer service skills including effective and efficient problem solving and analyzing skills.

LI-DNI

++What We Offer++:

Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace.

Benefits include:

• Medical, Rx, Dental & Vision Insurance
• Personal and Family Sick Time & Company Paid Holidays
• Position may be eligible for a discretionary variable incentive bonus
• Parental Leave
• 401(k) Retirement Plan
• Basic Life & Supplemental Life
• Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts
• Short-Term & Long-Term Disability
• Tuition Reimbursement, Personal Development & Learning Opportunities
• Skills Development & Certifications
• Employee Referral Program
• Corporate Sponsored Events & Community Outreach
• Emergency Back-Up Childcare Program

++About Guidehouse++

Guidehouse is an Equal Opportunity Employer–Protected Veterans, Individuals with Disabilities or any other basis protected by law, ordinance, or regulation.